Chloe 11

I should have given her the full dose last night. I'll do a curve tomorrow.

 

The insulin seems to have no effect whatsover. This morning she was in the 500's and I gave her 2 units. Eight hours later, she's in the 400's. I had worried all day that she might go hypo after such a high number. What do you think I should give her after dinner (in about 2 hours). She's eating her wet food now cold out of the refrigerator. I didn't even have to warm it.

 

Looks like she might be bouncing from that blue 142. Stick to 2 u for now. Get a test before bed.

 

I've spent all morning trying to figure out my new cell phone and now I have a huge headache! Why do they say 'caller is unavailable, try again later' instead of just saying you've run out of minutes? Okay, I will have to make a written list of all the questions I have and go to one of their retailers (who are usually too busy selling stuff). Never mind. I just tested Chloe and she's dehydrated because it takes me several tries to get blood out of her ear. I'll clean her litterbox and get another ketone test later today. I still think her dose is too low and want to go back to a fat 2, but I'll wait a couple more cycles and see what you have to say.

 

Well, I'm totally flamboozled. Do you think we should try a different insulin?

 

I wish somebody would help me.

 

I'm not sure why you want to try a different insulin, but if that feels the right decision, go for it. I would be sure to read the stickies in the Lantus forum if you decide to go that route though. I can't give much advice here since I've only ever used ProZinc, but you might try posting over there to see if they can give you more information/advice. We've had a few people move from here to there so they can give some insight I'm sure and they can give you some idea of why they did that and how it worked.

 

If you do decide to try Lantus, Roberta, be prepared for a strict dosing/monitoring routine. There's less flexibility in dose timing that with ProZinc. Skipped or missed doses as well as early or late doses affect the Lantus depot and can lead to erratic results. It also takes more time to see the effect of a dose. It's a gentler insulin and can smooth out some of the bouncing but it does impose a stricter structure on the human.

 

I'll stick with ProZinc then since I'm working now. She had a very high number this morning and I'm worried she'll go hypo when I'm at work. She was very hungry and yowling loudly for food this morning, but is alert and moving. I'll come straight home from work and should be back at 4ish. Good, she's drinking a lot of water right now.

 

As long as she's getting higher readings you should do ketone tests.
I see she had two blue preshots. Very nice. The 1.5 looks like it worked well on her blue preshot.
Getting more water into her is important. If she'll eat the wet food with some water added that's a great way to get her hydrated. I do this every meal and ever snack with Chuck. He drinks less out of the fountain now but I know he's getting at least 8 tablespoons a day.
If you ever need a quick response it don't think you're thread is getting read, you can tag people. Just use the @ and type their name right after it. No space between the @ and the name.
I do think she might do better on a longer acting insulin but as Kris said it's very strict compared to the ProZinc protocol. You have to do what's best for you and Chloe.
How's she doing? Hopefully she's getting back to normal. I would focus on keeping her hydrated and testing for ketones regularly. Sounds like her appetite is back.

 

I sent her spreadsheet to the vet and she wants her to come in for a glucose curve because she's been all over the place. I was reluctant at first, but she said she hadn't seen Chloe since April. I was concerned about the stress to Chloe, but she said that Chloe did well in April and also last month in the hospital. Also, they use Feliway in all the rooms. So, I'll have to get up extra early on Tuesday to take her in, but if it helps get her dose right, it's worth it. She said I should be more consistent and should have given the full 2 u the other day when she tested at 112 because she was eating. It's been eight months and she still isn't regulated. I found a way to test for ketones when I'm not home and gotten a couple of tests in. She's been negative. She must be drinking more water because I had no trouble getting blood the past few days. If I can get her regulated, I won't worry so much when I'm at work. I keep thinking that one day I'll get home and she'll be dead. My pottery classes will be starting soon, which will keep me away even longer, because I go directly from work. Her appetite is really good. I'll have to make her more bowls in pottery.

 

Oh, I ordered a water fountain from Chewy which should get here in a few days. I hope she'll like it.

 

There is still stress at the vet. Driving there and back. Keep in mind that even if the vet does a curve you'll have to get one at home too. Along with mid cycle tests. She's already proven she can do well on a low dose. With the higher carb food she's handling the 2 units well.
I think you made the right call lowering the dose that day. If you won't be home to monitor, you can't guarantee she will eat more food to steer her own drop. That's why mid cycle tests are so valuable. They prove what the insulin is doing with her numbers.
You should look into getting the petsafe 5 feeder. It's simple to use and can make sure she has access to food at important points in her cycle.

 

My cat's love their fountain! My civvie plays in it.

 

A water fountain is a great idea. Helps keep their water fresher since it's moving more.

Remember that around 50-120 is what we consider "normal" for cats. So that 112 you got was really within the normal blood range for a non-diabetic cat.

 

But should I still give her insulin at 112? She ate a lot so when I tested her an hour later, she was almost at 200 and that's when I gave her 1.5 u. Tonight, she vomited a bit of clear liquid before dinner. She ate almost a whole 5.5 oz can of Hill's! The girl has an appetite, but she's still skin and bones. Also, the vet told me not to take any glucose readings and stick with the 2.0 units until Tuesday when she goes in. Give her ear a rest. I'm just watching her behavior closely. Have a nice weekend, Rachel and Steph!

 

You have data proving on lower bg preshots you need to test.
Your vet clearly doesn't have the experience of caring for a diabetic cat. If you had a child on insulin, would you give them insulin without testing first and monitoring after?
Not testing is a good way to cause trouble and possibly harm Chloe. You have seen the proof in your SS data. Please do not listen to your vet about testing.

 

What's the point? I have to keep her on 2 units until the vet does the curve and finds the right amount. Like I said, I'm watching her behavior. I can tell when she's not feeling well.

 

The point is so that she doesn't have a hypo (since many cats do NOT show signs of it so you wouldn't know just by watching her behavior). Hypos can kill. You've seen her get a hypo number at preshot. If you give any insulin on say a 40 preshot, it will be catastrophic.

 

Absolutely agree with Rachel.
The point is keeping Chloe alive.
ETA: When they go too low or hypo, like you have seen before, they are extra sensitive to insulin for a bit afterward.
I just can't understand why your vet would want to put Chloe in any danger.

Why risk it?

 

This morning I was supposed to take Chloe to the vet for a curve. As soon as she saw the carrier, she bolted. I cancelled the appointment. I tried 2 times to draw blood this evening, but she's very dehydrated and I couldn't even get a speck of blood. I received the pet fountain today, but it may take a few days for her to get used to it. I will try to get a BG reading later tonight.

 

After DKA you need to keep a close eye on her hydration, ketones, and BG levels.
You should be encouraging her to drink and adding water in with her wet food.

 

I've already been doing that. When she gets to the bottom of the bowl, I swish some water around in the can and add it to her bowl so whatever is left is turned into soup. I had no trouble getting blood from her ear this morning. She was in the upper 200's. She threw up last night, but at least she had the courtesy to do it on the floor. Fuzma coughed up a hairball right next to my pillow. I tried to push her off, but she's pretty solid and dug in.

 

Seems like it's a good day for kitties to be butt heads. I woke up to Chuck combing my hair with his sh*tty foot. He gets poop stuck on his feet sometimes. He was trying to snag some of my hair to chew on... Over and over again. Never been so happy to wash my hair!

 

I'm sorry you didn't enjoy Chuck's hair combing experience

I know at your expense but that made me laugh out loud

 

Steph...I don't want to laugh...but I can't stop myself!

 

!!!

 

Wow! That's more disgusting than sleeping next to a hairball! Phew! You might have to sleep with a shower cap on. btw, Chloe seems to be evening out.

 

haha it was awful but I can laugh about it now. He hasn't had sh*tty foot in a while.
Hopefully she is evening out. Do you plan on doing a curve this weekend or making a new appt at the vet? I think doing one at home is better since there's no stress from the vet.

 

The vet tried to convince me that she wouldn't get stressed, but she did when she saw the carrier. I think I'll just take care of her at home. I can do a curve on Sunday. I don't think I like that vet. I liked the vet who took care of Chloe in the hospital, but it might be more expensive.

 

Again, I took 2 readings just a couple minutes apart and there was a huge difference. First one was 295 and second was 336. Chloe moved just as I pricked her ear and there was a lot of blood. I'll use the Everpaw when I do a curve. What is the control solution for?

 

Those two readings are within the 20% variance allowed for meters - ie. the difference isn't technically significant. Control solution is used the way you test a blood drop to see if the meter and strip is giving a reading within the allowed range that's usually printed on the strip bottle.

FWIW: I leave a carrier out for the cats to see all the time so it's not an "event" when I pull it out for a vet visit. I live in an apartment so I go close all the doors to rooms they could escape into before I start the getting into the carrier process. I've also put the carrier up on the counter in the bathroom long before it's vet visit time and then carried the kitty to the bathroom and shut the door. There isn't any place to escape to then. A little advance planning can help a lot.

I don't see regular pre shot tests recently, Roberta. Mid cycle on weekends or evening data on work days would also be very helpful. I truly think that it would be possible to get Chloe regulated if you're willing to stick closely to a structured testing/dosing routine over time. We all understand the time commitment involved and have to work the rest of life around FD but it's worth it when you see your kitty gaining weight and thriving.

 

Here's a great handout on cat carrier's. Agree with Kris on keeping the carrier out all the time. I used to store them in the closet, now they're open with toys in them, they nap in them and it really made a huge difference in getting these furbabies into the carrier and off to the vet.

 

I agree with Kris.

I do the same with mine. I have a small dog carrier because Kitty was 20 pounds. They play and sleep in it.
I think the home curve is a good idea but you have to follow through with it. I also think the mid cycles Kris mentioned will help to decide when the right time to do the curve is. Doing a curve on a bounce cycle won't give you any useful information. BUT doing a curve on a normal cycle (to be determined by spot tests) will give you useful info.
I think a curve on the yellow and blue preshots are your best bet.

Also wanted to mention... You said you have to keep the 2 unit dose. I agree. If the 2 units is taking her lower than she should go (shown by spot tests) you can increase the carb level of her food a little and still give the 2 units and reduce her bounces from the lows.
Before we were telling you to lower the dose to keep her from going too low and bouncing. Keeping the dose and increasing the carbs is the other way to handle it.

 

Kris, I was following my vet's advice to not test her. Also, I know about leaving the carrier out. Subconsciously, I didn't want to take her to the vet, and she agreed. I've had a lot of experience with cats.

 

As you know, though, it is extremely dangerous to not test her. You've had experience with cats, as you say, and you've had experience with Chloe going far too low even at preshot time!

 

You said it yourself.
In my opinion, your vet's advice about not testing is wrong. It turns my stomach to think any vet would want to tell a client to shoot blind and not monitor after seeing the history of readings in the 30s. It's reckless and dangerous.
How can you treat her properly without knowing how the insulin is working? I'm not saying you need to test like I do. But I think 4 tests a day 6 hours apart is not harder on the body than crazy high numbers from unseen lower numbers.
It's a small price if inconvenience to pay to prevent any crisis from happening.

We all approach FD treatment differently but with the same goal in sight. Regulation. Without testing... How would you know she's getting close or even in regulation numbers?

 

I think the vet didn't trust me to do it. She saw my spreadsheet. Anyway, I think I will try to find another vet.

 

I don't think the ProZinc is working anymore. It's close to the bottom.

 

When did you start this vial of ProZinc? It should be good to the bottom if stored properly.

Your vet has no control over what you do with Chloe at home, Roberta. Testing regularly is the only way to know what's going on, as you saw when you've had those lime green numbers on occasion. You have to really commit to doing it though. I don't think trying another insulin or finding another vet is going to help much. If you look at other spreadsheets here you can see - in colour! - what a structured routine can accomplish. Some people test a lot, others less so. I think that 3 to 4 tests every day at key times will give you good data that can guide you in getting Chloe regulated. That, along with making the time in your schedule to give her insulin on as close to a 12/12 schedule as possible, is the key.

You've already dealt with DKA, one very serious complication of FD, and I'm sure you don't want to go through that again. You've said that Chloe is extremely thin. This is related to unregulated FD. Yes, this is a time/energy/motivation commitment that you have to make into the foreseeable future. It's a very treatable condition but does require these things from the care giver. That truth is inescapable.

 

I have been doing very well with the 12/12 shots lately. I am committed to Chloe, but I am moving to a different school on Monday after being at the same school for 7 years. My arrival time is going to be almost an hour earlier, so I will have to change my wake-up and shot time for Chloe, which I will do gradually over the weekend. I will have to get her shot time to 6:30 am/pm. I don't know if you work or not, or do anything besides care for your cats, but if I'm that bad, maybe I should just put her out of her misery. Somebody has to pay for her cat food and vet costs, and that somebody is me. I said I would do a curve on Sunday using the Everpaw meter, so I don't know what else you expect from me. You're not being very supportive. And, by the way, I have looked at other spreadsheets. And Chloe has had only one or two hypos in over 6 months, which I think is good.

 

We all are just laying it all out there.
There's no need to put her to sleep. That's a bit extreme.
We know you said you'd do a curve on Sunday. We are telling you our opinions and the reality of what needs to be done in order to get her FD regulated. A lot of us agree that the vet is wrong for telling you not to test.
The curve is great info but only one day. Spot checks give you an idea of what's going on every day.

 

Look at my SS.
If I only did the curve on the morning of 8/10 it would tell me Chuck needs MORE insulin. Then look at the two following cycles. If I did an increase based on that one curve and NOT tested at all he would have had a pretty bad hypo crisis.
This is why we urge people to get some spot checks along with their regular curves.
We are trying to be supportive by giving our best advice.

 

I'm thinking that every time you change a dose, even by only .25, it causes a bounce. I'm going to start a new thread, Chloe 12. Can I delete or archive old threads?