? Dosing advice and general help

Discussion in 'Prozinc / PZI' started by Chloe007, Nov 7, 2019.

  1. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I'm feeling completely overwhelmed and I feel like I'm driving myself a bit crazy here, guys. I feel like it's just been one worry after another since Oscar has been diagnosed on Oct 24th (I also apologize if I've been driving you all crazy with my questions).

    I'm starting to get nervous. For those who don't know, my cat Oscar was diagnosed a couple weeks ago and was originally started on 2u. I was also told to absolutely not home test, and to not go looking online for help (lol). Well considering I highly suspected Oscar went hypo his first shot, I threw that advice out the window very quick and came to you all. It was suggested I start at 1u 2x per day (he only spent 1 day at 2u). I got a meter and was finally able to test him, and I've been trying to take full advantage of that. Which is why I'm a worried wreck now. HIS NUMBERS JUST WON'T GO DOWN!!! And when they do go under 400 he starts acting strange. He gets very lethargic like. When he's acting like himself, his numbers are often above 400. After a few days of nothing but red and black numbers, I increased to 1.25u. Followed by more red and blacks, I started him at 1.5u today. Earlier today his BG was higher at +6 than it was at his AMPS. He's still urinating and drinking water like crazy, and he's never not hungry.

    His diet has been fixed, he's eating 3 cans of FF pate a day (sometimes a little more when he's acting real hungry, but never 2 hours before shot time), and we took dry food away about 3 days ago. I give him dried freeze chicken bites for treats. It's really done nothing to help his numbers. I've been researching day and night, trying to do everything right, and I feel like I'm just hurting him. I feel like it'd be harmful to keep titrating so slowly, when he's been in high numbers for this long. Could a larger increase be warranted in this type of situation?

    I almost feel like I'm taking in so much information at once that I'm starting to confuse myself. I'm hoping someone could take a look at my SS and help me figure out a plan here. I trust you guys more than I trust my vet at this point, any help would be appreciated.

    Btw, I've been testing for ketones and they regularly come back negative.
     
  2. Jenna Josie

    Jenna Josie Member

    Joined:
    Jun 30, 2018
    Deep breaths, Chloe! You’re doing great. It IS very overwhelming at first (and sometimes later, lol), but you are doing a terrific job gathering data and learning what you can do to help Oscar. I know it’s hard, but my advice is to wait another couple of cycles and see what you learn with all of the testing you’re doing: he had a nice response on the 4th cycle after you raised to 1.25 (still high, but a very nice drop by +4). My guess is that the next morning’s high number was a “bounce,” the result of going what was — for him — “low.” (Probably the same thing after Halloween night.). Often it can take a few cycles for them to settle into a dose increase, so hard as it is, we just have to be patient and wait and see.

    Remember that he was probably diabetic for awhile before you knew it, and it can take a little to get him regulated.
     
  3. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thank you for the advice! I actually am feeling a little positive right now, I just tested him at +2.5 and he was at 310 so I'm feeling really good about that. And for once he's not acting weird like he usually does when he drops below 400. He's running around with his sisters and being a little goofball, I think he's feeling good. Thank you for the reassurance, those numbers from the 2nd-5th were really starting to worry me. I just want him to be feeling better. I'm hoping this last dose increase will do it, but I'm not holding my breath (fingers crossed I don't get some crazy number in the morning). Thank you for the help, Jenna.
     
  4. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Jenna has given some good advice and I think I can say we have all been there -feeling overwhelmed, confused and worried we are not doing the right thing. I was a mess when I started and If it were not for this group I don’t think I would have made it this far , at least not without a nervous breakdown!! Some of the best advice I was given here is “this is a marathon not a sprint”. You are not going to fix this overnight. Take some deep breaths, keep testing and once you gather enough information as to how he responds to the doses throughout the cycle, the wonderful people here will be able to advise you about dose changes. You got this! Hugs to you and Oscar!
     
    Tina R and Chloe007 like this.
  5. Sarah&Soph

    Sarah&Soph Member

    Joined:
    Jun 18, 2019
    Something you’ll see here often is “diabetes is a marathon, not a sprint!” I definitely know the feeling of wanting our kitties to feel better immediately, but it can take some time. You are doing a lovely job so far :cat:

    And as others have already said, it’s possible Oscar was diabetic for some time before he was diagnosed which might be why he acts “weird” when his BG starts getting lower. It could just be that he’s not used to those numbers anymore, but hopefully he will get used to them soon! He could also have some glucose toxicity depending on how long he was diabetic before being diagnosed so it may take a bit more insulin to get his numbers down, but small gradual dose increases like you’ve been doing is the safest way to get there
     
    Chloe007 likes this.
  6. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Hi Jenna! So today we had an unexpected blue (123 at +8) after he was at 491 this morning. I unfortunately didn't get anything earlier than that because I'm running low on supplies and money so I've been trying to be conservative, I should be able to get some more tomorrow for extra testing though. Anyways, becaus he's so used to high numbers and with the 491 this morning, that drop so late in his cycle has me a bit concerned. I know it's a good number, it's just such a big drop, and he had a whole can of FF at +6 so I can imagine he was probably pretty low before that. Do you think I should do anything different at this time or wait until I get more mid cycle data for this dose? It was just so unexpected, and of course on a day where I didn't test much.

    I'm going to obviously test him before his PMPS, if it's below 150 still...should I shoot?
     
  7. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    If Oscar is below 150 at shot time, stall without feeding him and retest 30 minutes later to see if his BG is rising on it's own. Chances are good he may bounce to higher numbers by PMPS from that huge drop today but we all know they can and do throw us surprises.

    Just how low are you on strips, lancets? Food of different carb levels?
     
  8. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Just how low are you on strips, lancets? Food of different carb levels?[/QUOTE]
    @MrWorfMen's Mom thank you for replying so quickly. I was also thinking he may bounce, that's what happened the last time he went to the 100's but I really don't have enough data to where I feel like that's a sure thing. I have 10 strips left but no lancets, and the strips I was getting are only available online (bad idea). I ended up having a friend offer to go buy more lancets for me and I will now be able to go to the store tomorrow night to get a new meter/new strips. So I have 10 strips until tomorrow night. Lancets I'll have in a couple hours, but if I have to I can reuse a couple that I've only used once and still have around.

    I have both low, medium and high carb food around right now too.
     
  9. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Good to know. So you definitely don't want any surprises tonight. Let's see what Oscar decides to do.

    A suggestion.....keep an extra vial of strips for whatever meter you are using in your hypo kit. Every time you buy new strips, just swap out the hypo kit strips for new ones. That way, you always have extra strips at hand should Oscar decide to throw you a low you need to monitor intensely for awhile and the strips never end up expired.
     
  10. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thank you for the suggestion, I'll definitely start doing that in the future. I'll know for sure what the deal is in an hour here, if you're still online I'll come back and give you an update!
     
    MrWorfMen's Mom likes this.
  11. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
  12. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Not surprised but I know how frustrating those bounces are. Regular dose is fine tonight but do get a test in before bed to see what he's up to.
     
    Jenna Josie likes this.
  13. Jenna Josie

    Jenna Josie Member

    Joined:
    Jun 30, 2018
    Totally agree with Linda: unsurprising and frustrating! Patience will help here, too, as it can take several cycles to clear a bounce. :bighug:
     
    Chloe007 likes this.
  14. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I just tested him at +3 and he's at 448 so I don't think we will have any big changes tonight from that high number. I am a bit nervous because I'll be gone from his +8 after am shot until +4 after pm shot. I have my boyfriend watching him and taught him how to test, but I hate leaving him after something weird like this happens.

    I had a question about ketones. I've been regularly testing Oscar and he always comes up negative, which is good. But when we first got blood results from the vet we were told he had some minor electrolyte imbalances, which I've heard is a risk factor for ketones (hence the regular urine testing I've been doing). My main question is, if one day I happen to get a result and he is above trace amount...how serious is that? I hear about people taking their cats to the vet in situations like this and they end up with huge vet bills to treat it. I'm worried I wouldn't be able to afford the costs. Do trace amount of ketones require the same type of treatment that's required with DKA? I'm sure there are variables involved, but idk, I'm just constantly holding my breath everytime I look at his ketone sticks and wonder what I would ever do if one came back positive. The vet did say he thought everything would even out once he's on insulin, but the way things are going and all these high numbers...I'm feeling super discouraged.
     
  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Any reading over trace on the ketostix means a vet consult is needed. Ketones can build up quickly and result in DKA which is expensive to treat and can be fatal. Regular testing is recommended but any time you notice Oscar off his food, particularly lethargic or any other symptoms he's not well, a test for ketones is a good idea. Keeping kitty well hydrated by adding water to their wet food and providing adequate food is key to keeping ketones away along with the insulin shots. Often ketones show up when an infection is brewing which is another reason to get kitty into the vet immediately if ketones are above trace levels.
    You've been at this less than a month and while we all wish we could wave a magic wand and fix them, we can't. It takes time to get a kitty regulated and it looks to me like you are making progress in the right direction so be patient. Those higher numbers today are from a bounce and they will pass but it may take a few days for that to happen. The highs are not because the insulin is not working but rather the opposite. As Oscar gets reacquainted with more normal BG those higher readings will lessen.
     
  16. Jenna Josie

    Jenna Josie Member

    Joined:
    Jun 30, 2018
    This! This is the hard thing to keep in mind because it seems so counterintuitive, but it is exactly right and why it’s so important to get at least one mid cycle number whenever possible.
     
  17. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thank you, I know I'm getting way ahead of myself here. I need to chill out a bit. We had quite the day today, when I left to go to work today when we were at +8 after his AM shot, he was at 402. Well I had my boyfriend over testing him and giving him his shot, and when he tested Oscar, it kept reading "low" even though he swore he was getting enough blood. So naturally I was at work freaking out, I had him feed him some HC dry food (although feeding was another problem because Oscar gets depressed when I leave at night we've noticed). I told him to test 30 minutes later and even directed him here in case it still came up low....but then he was at 480. We don't know what happened, but he got his shot. Normally I would have asked you if we should reduce....but I think that low result was very suspect. He was at +11 when he tested him...at +8 he had been at 402. I bought a Relion Prime when I got off work tonight, we did our first test and got a 372. Should I keep using the same spreadsheet or start a new one with the human meter?

    @MrWorfMen's Mom
     
  18. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom I think I got bamboozled again here. I nearly just died a little. I was able to obtain a ketone urine sample tonight and when I first looked at it...it started getting darker than I seen before, and really fast. I had a million thoughts going through my head, but it didn't quite look like any of the shades yet I could just see it was darkening. So in that time I ran downstairs and gave myself a test so I had a negative one to compare to, but the plan went awry. My ketone stick came back obviously positive. I went back up and checked Oscars and his had settled down to a lighter brown color (that doesn't match any on the guide) but it was still darker than his previous negatives. Now I'm a little worried about that, but I also don't know if I should make anything of it since mine came back so wacky...maybe the bottle just went bad? I can't imagine why I would have ketones. But assuming the bottle is okay, what do you think of these results?
    http://imgur.com/a/eJtxI4p
    The first pic will show his from today 11.11, the second will show his from 11.4 and the third was my comparison that awry

    and heres one more pic of the same one from today of his
    http://imgur.com/a/HBIaQzN
     
    Last edited: Nov 11, 2019
  19. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    When using the ketostix, it's very important to be in a place with a good light source and to ensure you are reading the strips in exactly the time frame indicated on the bottle (usually 15 seconds) following dipping the stick. The colour will continue to darken the longer you look at it. It's hard to reach a firm conclusion based on pictures because all of our screens may display colours a little differently but if I had to guess, I'd say Oscar's tests are neg to trace and yours definitely looks more like small to moderate. Any chance you have been eating a keto diet (no/very low carbs) or ate much less recently? If you happen to be diabetic then yes I would say yours definitely need watching. What's the expiry date on the bottle? It's possible the strips could be bad but the only way to tell would be to try another bottle.

    The other option for checking ketones is to get a glucometer that tests ketones as well as glucose. The Precision Neo by Abbott and Nova Max Plus are two options. The blood ketone strips are a bit more expensive but ketones show up in the blood before they show up in the urine so you get an earlier warning if ketones are rising. With cats the level of ketones with a meter needing a vet consult is about 2.3 (I could be off by a point or so there) but it's different than it is for humans.
     
  20. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I'll probably look into a ketone meter so I'm not constantly second guessing myself and driving myself crazy. It drives me nuts that the negative/trace colors don't look anything like the ones on the bottle..they look brown. But when I looked at them in real life, there was an obvious difference between mine that was bright pink and his that was a neutral brown, so I think all is probably well and I was just overthinking it. I think I looked too quickly, because it started turning dark but then within the 45 second time frame it settled down to that brown color, where as mine didn't. Funny that the one time I need a negative one to compare to, I test positive haha, but I think it was equally as helpful. I checked my blood sugar to be sure after that result and it was fine btw lol, but I'm not on any kind of keto diet so I should probably keep an eye on that haha. Thanks for the second set of eyes, as always it just helps to have any kind of second opinion even if accuracy isn't all there.
     
  21. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Another option is the Keto-Mojo. That is the one I have.
     
  22. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom

    Hey there, so for the past day Oscar's ears are looking pretty rough. His right ear (that has been used much more often) is looking red, has little white bumps near the poke spots, and is feeling a little warmer than the other, so I want to try to give him a small break from testing. I'm still doing 2 today just to make sure he's safe, but I think that's all I'm going to do both today and tomorrow, they really need to heal, and I don't want them getting infected. This doesn't feel like it's just typical, minimum poke trauma, but a little bit more. We're also making the switch tomorrow from his 20% carb dry food to Dr. Elsey's (he has IBD and the only thing that keeps it at bay for whatever reason, is having some type of grain free dry incorporated in his diet). So despite feeling like he likely needs another increase very soon, do you think it would be fine to wait a couple days to give his ear's a chance to heal and to check for any effects the new dry food has on his BG?
     
  23. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I understand you wanting to deal with both issues at once but quite honestly, it could be dangerous to switch out 20% dry for the Dr.Elsey's and NOT be testing. The change of food could have a dramatic lowering effect on Oscar's BG so if I were you, and you need to keep testing to a minimum for a couple of days, I'd hold off any dietary change until his ears are better and you can get some mid cycle tests. If his left ear is OK, I'd still suggest grabbing at least one mid cycle during the day and at minimum a before bed test to keep Oscar safe. And definitely don't increase his dose until you can adequately test either.

    Was it meter failure this AM or did you not get a pre-shot test? Pre-shot tests are the only way to see if it is safe to give insulin and mid cycle tests ensure that BG is not dropping too low. While I doubt he's dropping too low, our kitties are known for surprising us on occasion so better to err on the side of caution. You could try putting some Neosporin with pain relief on his ears to help them heal.
     
  24. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    It was a mix of both. We switched to the Relion this morning and I tried three times not realizing what I was doing wrong, two times were because I tried to take the sample on the wrong screen (I think I didn't have it fully set up or something) and the third time was because I didn't get a big enough blood sample. I think I just had to get used to practicing with that meter a couple times, and we switched to a thinner lancet because I think that was what was contributing to the painful looking ears (the lancets that the pet meter I was using before came with were 21g, we switched to 26). I couldn't stand to poke him again, and knew I'd be home today and could watch over him. It wasn't my intention to not get a preshot test, I would have rather had that but settled for the mid cycle test when we couldn't get it done. The mid cycle test went really well, and I don't think we will have problems with the new meter or lancet from here on out.

    I can definitely do the switch slowly, I think things may look better once we're on a set feeding schedule for him. Things were a bit rocky up until now, we tried to do all wet for a couple days but the diarrhea started up and so we incorporated the dry back in. So he's currently eating a can of FF before each shot, and he gets a handful of dry food in between each shot (meal/shots are at 8am/8pm and his dry snack is at 12am/12pm currently). I was thinking about mixing the two and slowly put more Elsey's than Crave in each day until he's fully eating just Elsey's. Would this be a good idea or should I just make the switch quick while monitoring?

    His ear's are looking a bit better today, it's just the warmth of his right ear is what has me most concerned, but it seems a bit better right now. In the meantime I'm just going to use his left ear and take it a bit easy for just maybe one more day. I've already been using Neosporin with pain relief, I also use Vaseline before I poke and hold the spot tightly afterwards to prevent bruising, I'm not sure why they're looking so rough. I was a bit worried about it becoming infected, but fingers crossed it get's better and not worse. I do have a Triple Antibiotic Cream I got from my mom when she took her dog in for a cut on her face. I was wondering if it would be safe to do that, just in case it is infected.
     
  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Glad to hear you got the human meter sorted out. I'm sure the 21g lancets are contributing to the ear issue. Those are huge and likely meant for paw testing rather than ears. In any event, you have 26g now so that should help keep Oscar's ears in better shape.

    Changing the food gradually is definitely the best way to go especially if you have found the switch is causing diarrhea. It also makes it easier to monitor BG changes and avoiding a sudden drastic drop in BG.
     
  26. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    We seem to have taken a huge step backwards it feels. I haven't updated his SS yet as I'm on mobile but his amps was HI and his +7 was 442. His symptoms that were getting better, seem to be coming back with a vengeance. Just constant drinking water and peeing today. Not sure what to do here, but staying at this dose feels wrong.
     
  27. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I agree it looks like a dose increase is needed but I think some of what you are seeing in high numbers is bouncing from the drops in BG like the drop from 453 to 280 in 2 hours last night. No telling how low Oscar actually went a few hours later.
    Our kitties have a habit of going lower at night than they do during the day. Any chance you could set an alarm tonight to test around +5/6 to see I Oscar has indeed dropped into better range?
    If you can test tonight and he doesn't drop, then yes I think you could increase to 1.75u but I would do so on a cycle you can monitor.
    How is the food switch going now? Are Oscar's ears improving at all?
     
  28. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I do have Saturday off, so I'll see how tonight and Friday go with the food change and if things don't get better I'll move up to 1.75u on Saturday morning. He did give me a 390 for his pmps we just did, so maybe that means the food switch is helping? It's been going well, in my experience with him, as long as he has some type of grain free dry food incorporated in his diet, he does fine. Still not sure why, but it works. His ears are worrying me less now too, I think easing off these past two days has helped them heal, I feel comfortable poking him a bunch again haha. He acted quite odd after the shot I just gave him, it's just been a weird day for us. Normally he barely notices and keeps eating his food, but this time he completely stopped, walked around a bit and wouldn't go back to it. He went to his water bowl and sat a little funny to drink his water, although maybe I was simply paying too close attention, idk. His tail was flicking around like he was a bit irritated, and he's now gone to his "spot" without ever going back to his food. He's reacted this way before, I'm not sure why it sometimes happens.

    It's also weird how all of a sudden after that really high number this morning, it's like he instantly started getting his symptoms back. He's been drinking so much water and urinating so much today. And yes, I'll set an alarm tonight to get a +5/6 in.
     
    MrWorfMen's Mom likes this.
  29. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Until you get these fur kids regulated, they will have ups and downs. Probably drinking more because of the higher BG. While they usually don't notice the shot when they have their faces planted in their food, sometimes they do. I think sometimes they maybe move just a smidge and feel the needle while most times they either don't feel it or they just don't care 'cause they are more interested in the food. As long as he is eating and doing normal cat stuff, no worries.
     
  30. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thank you, I've definitely been over analyzing his behavior lately haha I'm sure he thinks I'm nuts o_O. His +2 was 258, and I'm going to try and stay up for a +5 and see how that goes. I'm interested to see if this food switch is going to help him from spiking back up by morning. I do suppose I should wait to see how the diet change will affect him, and wait for that to settle before I raise his dose. Either way, I should probably have a good idea by Saturday I think. I highly doubt the switch will be enough to keep him from needing the increase, but it will help me get an idea of what his low's will look like once we do.
     
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    While the food switch will lower BG overall and therefore likely diminish the higher AMPS, it won't stop the higher AMPS completely, at least not immediately. The lower the BG gets, the more used to those lower numbers Oscar will get and then the BG should smooth out more across the entire cycles.
     
  32. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I fell asleep literally right before +5 last night, so I'm going to get those later PM cycle numbers tonight instead. Today's numbers are looking a little better, but Oscar is still acting weird. AMPS was 371, +2 was 250, +6.5 was 326....I was at work from +2 until +6.5, ideally I'd like to see what those numbers are so I'll get that done on Saturday. He's still drinking and urinating a ton, acting lazier than usual/walking a little slow, but seems to be eating okay. His food consumption has gotten better so the slight decrease in his eating isn't concerning me too much. Maybe he dropped lower than he's used to when I was at work, and he's just not used to those numbers right now? Or the jumping in numbers is making him not feel very well? We got a negative ketone test today, it was lighter than the one I showed you a picture of the other day. His ears are still warm, and I'm still not sure what that is about.
     
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Yeah for negative ketones. Oscar is dropping a lot very early in the cycle. Can you feed him a bit more canned food before his shot? Or perhaps offer him a snack of canned food around +1.5 hours post shot to see if that slows down the drop a bit and extends it out further into the cycle. Some of the bouncing may be happening because of those steeper early drops. It will be interesting to see what his readings are in that +3 to +5 timeframe when you can manage it.
     
  34. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Lately his hunger has been much more manageable, so he gets more to eat than he actually consumes as is. I leave it out for him to keep going back to if he wants and sometimes he will, and sometimes he waits until his timed feeder opens up with dry at +4. He definitely was eating more wet food when we took the dry food out of the equation (obviously) but we just can't do that due to the IBD. He basically always has food available except for the two hours before shots. So I'm not really sure how I can get him to eat at +1.5. I could try restricting food/ less free feeding so he's hungrier at shot time and eats more wet food then? He's usually always willing to eat chicken Pure Bites, maybe I should get more of those and give them to him at +1.5. Hmmmm.

    He definitely perked up a couple hours ago, and has been acting like himself since about +9...I do think that big drop is causing him to not feel well, and then when he comes back up near the end of his cycle he starts feeling better.
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    They get so use to those higher numbers that the lower numbers even if still not normal don't feel "right". It takes time. I remember when my girl was starting to make progress, she seemed to feel off when in good numbers and better sitting in yellow range. That went on for awhile. Maybe you could try giving Oscar a bit less wet at shot time and put the remainder in the feeder for +1.5. He might be more willing to eat then if he eats less pre-shot. Just throwing that out for consideration. You know Oscar best and sometimes it takes some experimenting to see what works.:)
     
  36. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I actually hadn't considered that, that may work. Part of the appeal for Oscar is hearing the sound the timed feeder makes when it moves over and he knows there's food there lol. So if I put wet food in there....it may just trick him! Now that his appetite has been less ravenous versus when he was first diagnosed, it's definitely setting up a challenge for us because he's going back to his old ways of holding out for dry food and I can't just simply take it out without him getting sick. I know I could get him to eat dry at +1.5 easily...but I also know I need to keep him eating wet food one way or another. I was thinking about looking for other users around here who have IBD kitties that also need dry in their diet to try and come up with some ideas here.

    As always, thank you Linda!
     
  37. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    You can post over in Health mentioning the IBD and see if anyone can help. Some IBD kitties do fine with wet food once you find the right one and dry food is more of a rarity around here but some folks still feed low carb dry for a variety of reasons. Some, like me just have a kibble addict who refuses to acknowledge that wet food is actually edible! Thankfully my girl finally realized that wet food was Ok but she'd still kill for a feed of kibble if allowed.

    If the snack of wet at +1.5 doesn't work, give Oscar his beloved kibble. Any food is going to help slow that drop. :)
     
  38. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I ended up getting him to eat a small amount last night when I saw he dropped to 283 at +1.5, he was willing to eat a couple bites when he heard that can open, but had no luck this morning. I'm going to do an hour by hour curve after his PM shot tonight, I don't work in the morning so I can stay up. I'm trying to decide if I should raise his dose in the morning. I feel like maybe that will let me know for sure that it's safe to do the next day? I was thinking maybe not even do a .25 increase but less, try and do very small increases until we have this food thing figured out. What are your thoughts, bad or good idea? (assuming he doesn't drop much lower than at that +2 mark during his evening tests tonight). I'll have to re think things if he is. Maybe I'm getting ahead of myself, but I feel like I've been at 1.5u a bit too long.
     
  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I agree it looks like Oscar needs a little more juice but I think you'd be fine with a 0.25u increase. No need to skinny it up. Get the curve tonight. Oscar may e dropping a little lower than you are aware of and the curve now will hopefully answer that burning question. Just give the 1.5u tonight and then change the dose tomorrow AM if warranted which I'm pretty sure it will be.
     
  40. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Do you think there's a good reason to do a curve tonight before raising his dose? Should I just go ahead and increase tonight and do a full curve on that instead? I feel like the curve won't turn up much more than we already know and now I'm wondering if I'm being too cautious, since I plan on poking all night anyways...maybe I should make it worth the testing...ya know? I have plenty of testing supplies and different levels of carb food just in case.
     
  41. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Don't raise the dose because there is a strange phenomenon called New Dose Wonkiness (NDW) which sometimes causes higher BGs when doses are increased. I'd do the curve on the current dose knowing Oscar is not bouncing at the moment and it should be a good representation of what the current dose is doing for his BG. All good info.
     
    Diane Tyler's Mom likes this.
  42. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Linda, I need to fully update the SS for last night when I get the chance but nothing surprising happened. I ended up missing his +2 but got pretty consistent testing in through the rest of the night. PMPS was 365, +1 330, +3 294, +4 289, +5 322, +6 297, +7 301....then I went to sleep and woke up to AMPS 355 and went ahead and raised the dose to 1.75u. I gave him a snack at +1.5 as suggested (I'm missing that +2 data so I wouldn't be surprised if that's when he went his lowest) but I think it definitely seemed to help slow down any dramatic drops. He had his dry food at +4 so I think that could account for the small spike at +5. I was pretty happy with his cycle last night, while still too high, it actually made some sense haha. Fingers crossed for the increase today :cat:
     
  43. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I was hoping you could possibly help me come up with a consistent feeding schedule for Oscar, as up until now it hasn't been as consistent as it probably should be and I'd like to have it worked out by the time we do his next dose increase...as it looks like that's where we're headed.

    Currently, he's eating 1/3 can of Friskies Pate twice a day (before each shot at 8am/8pm). Sometimes he finishes it all, other times he doesn't. Usually eats at least half of what I give him. I switched back to Friskies instead of FF because my other two girls didn't like it, and if they are each eating something different, it's like a game of musical chairs. So instead they each share one can split up before each shot. Then a 2/3 cup of Dr. Elsey's is split up into four equal sections in the timed feeder. 9:30am/9:30 pm and 12:00am/12:00pm. The three cats share this, but Oscar does eat a little more than the girls. For the record, he does need to gain some weight back.

    Does this sound reasonable? At least until we can slowly start replacing the dry food with wet? Most nights I try to entice Oscar with some wet food for that 9:30 snack, but it often doesn't work, and the dry food he eats at that time seems to help with slowing those big drops we were seeing.

    And also, he had a 533 this morning. I can't be too sure what happened last night, when I went to sleep he was at 303. I'm not sure if he dropped lower than I anticipated, but according to my roommate he started scouring around the downstairs before she went to sleep (a place where the cats never ever go) and the beta fish she saw him eyeing, was gone in the morning...with water all over the ground. So he ate the beta fish. So I'm not sure if that high number is from a bounce because he went low, or because he ate a beta fish...or some combination of the two. This also makes me think he's not getting enough food....but I don't want to be feeding him too many calories.

    Any suggestions?

    @MrWorfMen's Mom
     
  44. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I think I might move the food times just a smidge. How about trying 10am/10pm and then 1:00pm/1:00am. This is something we are just going to have to play with a little so it may need adjusting but that's just part of the process.

    While the Dr. Elsey's is low carb, I'd be careful with the portions because it is really calories dense. As long as you are sure the other kitties are getting a reasonable share of the kibble, that's fine, but if you know Oscar eats more, an extra helping meant for the others could also elevate his BG.

    I'm so sorry to hear about your Beta. I take it Oscar wasn't in the habit of wanting to eat the fish previously? I suppose he could have been hungry and gone after the prey but could it have been an accident of knocking over the fish bowl and opportunity knocked?

    He may have dropped lower last night and is bouncing now but the only way to catch those drops is to use night time bathroom trips or set an alarm to test later into the night cycle.
     
  45. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Sounds like a plan, I'll move the food times up and keep things the way they are for now otherwise, I'll also try to figure out exactly how much of the dry food he is eating versus the other cats. I think maybe the later food time (1am) will help him not get so hungry during the night, he usually eats throughout the night once his timer opens...but I think last night he ate it all too early and was hungry again by later in the middle of the night. Idk, last night was a weird night for him. And no, he never tried to eat the beta before lol. It wasn't an accident, the bowl wasn't tipped over...just a missing fish and water splatter on the ground (I presume from him scooping the fish out). Unfortunately it wasn't even my beta...it was my roommates :oops:. Luckily she is very sympathetic to Oscar's "changes" lol. Totally out of the norm for him though.

    I'm thinking give this new dose a couple more days and revisit a dose increase then?
     
  46. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Oh dear! No more live fish in the house I guess. While Oscar may seem the logical suspect any chance one of the others might be the culprit? Just saying. I'm glad your roommate is understanding.

    It's looking like Oscar is going to need more juice but I would increase to 2u only when you can monitor closely for a cycle or two.
     
  47. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I could start banging my head against a wall today. It looked like things were settling after that high AMPS yesterday, and his AMPS today was looking much more like our current "normal"....I get home from work at +8 and he's at 511. What the hell could have happened? He's been all over the place with these numbers lately.

    I have the weekend off, so I'll increase then so I can test as much as needed. For some reason this doesn't feel like a bounce...I've never caught him under 200 so I have a hard time believing this is a bounce, instead it feels like his insulin starts to wear off too early.
     
  48. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    You may be right about the duration. Looking at those cycles where you've been able to get more tests, it quite often appears Oscar is hitting nadir around +4 or so. It's possible he is dropping lower than you are aware of earlier in the cycle when you are not able to test and then bouncing up.
    He doesn't have to drop below 200 to bounce. He just has to drop quickly, more than his body thinks is safe or just to a level his body now considers unsafe because he has become so used to higher BG.

    Are you absolutely sure there is nothing in the way of contraband he might have found? There was a member here who had an extra bag of kibble (I think for her other kitties) that her extra sweet kitty found in a closet and chewed a hole in to get what he wanted. Another had one stealing dinner buns amongst other things. My girl once tried to eat a peanut butter sandwich. The possibilities are endless with a determined kitty.
     
  49. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Yeah I get that, I just felt like his cycles were starting to look more "stabilized" the past few days where I was able to test, with his AMPS usually being around 350-380 lately, the 200 somethings I was able to catch didn't feel like it should be such a dramatic drop that it would cause a bounce, but then again, I haven't been able to test during those peak hours the past few days so it's totally possible something has changed in that time.

    I think I may have figured out today's issue. After much thinking, and searching around the house to try and find some contraband he might have gotten into (he is known to chew through bags of treats and dry food, but those were all put away, didn't appear to be broken into) I realized I made a big mistake earlier. This morning at AMPS my other cat who is a very picky eater, turned her nose up at two different pate's I put in front of her...so in my frustration I opened up a can of the Friskies Saucy Seafood Bake that I had from pre-diabetes diagnosis, and put it on the landing for her to eat by herself while Oscar was upstairs eating his pate. I was supposed to pick it up after she was done eating and before I left for work, but was in a rush, and didn't notice it was still there until I was searching through the house for contraband. I looked up the carb count and found it confusing....the website I found said it was 7.5% in the "guaranteed analysis" while it said 34% for the dry matter analysis 'normalized for moisture content'. Those are obviously two very different numbers, and I don't know enough about reading labels to know which one I should be looking at, but either way, it's more carbs than he's been getting from his wet food. So I think that may solve today's mystery at least.

    I decided I'm going to take him back to the vet next week to do another full blood work up, it's been about a month since his last work up when we found out about the dx. His eyes are looking a little runny, which isn't unusual for him, but that along with his ears that are at times oddly warm I just want to be 100% there's not an infection going on. I'm finding myself so constantly worried about DKA that I think it would just make me feel better to know there's no infection or anything brewing. I'd also like to get his records/test results from the last time we were there...and I'm guessing I'll need to go in for that.

    Anyways thank you for the idea to check around for contraband, I really didn't think there was any way he had gotten into anything and probably wouldn't have remembered my mistake if I hadn't done that walk through!
     
  50. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Having 3 kitties myself, two of whom are grazers I know all too well how difficult it can be to avoid those occasional pilfering escapades. My extra sweet girl dives in and finishes her meals but then will push her brothers out of the way to scarf down their meal too. Luckily they are on diabetic safe food BUT she has food allergies so I still have to play lunch room monitor at every meal. When I have to go out for lengthy periods, it's no doubt a free for all on many occasions. Now you know Oscar will go and pilfer so just be on the lookout. None of us can monitor them 24/7 but take necessary precautions when you can.

    Chances are good the carb count for the Saucy Seafood is high. Guaranteed analysis can give some pretty misleading numbers on occasion. Go by the dry matter analysis numbers.
     
  51. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Will do! He dropped to 336 by his pm shot, so I feel like that must have been the issue....if he was just rising on his own, I can't imagine he would have dropped so quickly. Once he dropped he looked like he was feeling a lot better. I'm feeling a-okay again! Thank you for talking me through this moment of confusion and panic!
     
    MrWorfMen's Mom likes this.
  52. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom

    Was thinking about upping his dose to 2u at his PM shot tonight. I do have a work meeting at 9am tomorrow (he gets his shot at 8am), will be home no later than 11am.

    Do you think it will be okay if he isn't monitored those two hours (likely even less)? He gets his dry food snack at 10am.
     
  53. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I don't see what Oscar did today on his SS but if number have not come down, which I assume they haven't, then yes, you can increase to 2u. Get a test when you get home. As long as AMPS is not low and with ProZinc onset not till around +2, Oscar will be fine.
     
  54. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Eh, I got cold feet and shot 1.75u. I'm quite tired tonight and was worried I would fall asleep before he dropped. Plus even though I probably wouldn't have tested him in that two hour window tomorrow morning anyway, I'd feel better if I was with him. I'll start tomorrow night. I do worry I'm holding doses too long, but I also worry much much more about hypo.

    I forgot to update SS, numbers still high. AMPS 402, PMPS 355.
     
    MrWorfMen's Mom likes this.
  55. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I really don't think you need to worry so much about a potential hypo situation and could increase the dose tomorrow AM but the choice is yours. Personally, I always preferred to make any dose increases on a day cycle when I knew staying awake if need be wasn't going to be a problem. You said you'd be back by +3, so I really don't think there is cause for concern.
     
  56. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thank you for the reassurance! I ended up increasing this PM, I'm a bartender so I tend to sleep in later during the day and am up later at night than most...so increasing at night makes sense for me :) I'll let you know how the increase goes!
     
    MrWorfMen's Mom likes this.
  57. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom

    We seem to be stuck in purples, can't break under 300. Ugh, you were right that I didn't need to worry about a hypo! I'm off work until Friday, so I'm hoping to make some progress with Oscar in that time. If no progress is made soon, when would be the appropriate time to increase again? If necessary, I'd like to start a new increase sometime this week while I'm home so I'm here to keep an eye on him.
     
  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Oscar finally is showing some yellow tonight so if he's still yellow tomorrow AMPS, then hold the 2u dose as that can be a sign that BG is coming down some from breaking a bounce. If he's back in purple at AMPS then bump him up to 2.25u and monitor. Tag me if any questions/concerns.
     
  59. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    He ended up all the way in red by AMPS, but he had diarrhea this morning, so I decided to wait until tomorrow AMPS to raise his dose. I'm guessing his IBD is acting up again because of all the wet food we've been trying to get him to eat :/. I'm making him a vet appointment tonight to get him in next week. Not really sure what to do from here...wait it out and see if it passes, take the wet food away? Idk.
     
  60. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I don't know if it is IBD or a bounce that caused that red this AM. It looks like it could be a bounce from the yellows last night. He almost was at red after the last time he saw yellow too which makes me think it's a bounce. That said, diarrhea needs to be dealt with. Have you tried plain pumpkin to up the fibre a bit? Certainly if the problem persists, it's going to be a matter of finding food he can eat without aggravating the IBD. I wouldn't take the wet food away necessarily but maybe slow down the transition or try a different kind slowly. That might help.
     
  61. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    He ended up refusing to really eat his wet food tonight anyways, he took a few bites, but wasn't into it. So I offered him dry instead, and he ate that with no hesitation. In the past when his tummy hurts, he doesn't want to eat wet food...not sure if he's somehow aware that it makes him not feel good or something, idk. I'll keep offering it to him, but I think it'll probably be mostly dry the next few days until he gets back to normal and we can try again with a different wet food. He has an appointment on Tuesday at the vets, just to put my mind at ease I want them to run some blood work and make sure there is nothing else going on (he just had some ran less than a month ago, but I'm paranoid. His voice has been a little wheezy too and I want to make sure there's no type of upper respiratory infection brewing).

    Also wasn't sure if that red was from a bounce or from pain, but when I just tested him at +2 he did come down to 268 again, so we'll see what happens tomorrow morning I guess. Do you think I should wait to increase, or does this not really change anything?

    Oh and yeah, I did try canned pumpkin. He wouldn't touch it, but I was kind of naïve and thought he would eat it straight up (like his sister's have done in the past, they oddly love the stuff). I'll try again tomorrow by sneaking it into his food. Thank you Linda.
     
  62. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    He's got to eat so feed him whatever you have to. Are you checking for ketones? Sounds like Oscar is a real kibble addict (been through that and know the frustation all too well) and going to make transitioning him difficult. It's not unheard of to have them turn down food they associate with not feeling well so maybe a different food would appeal more.
    I think his BG is high enough you can increase as long as you can monitor and Oscar is willing to eat the crunchy stuff if nothing else. Get the vet to check his teeth as well. It's quite common for a little inflammation of the gums or bigger tooth issues to cause higher BGs.
     
  63. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I've been checking for ketones daily, sometimes they come out lighter than anything even on the chart, sometimes a bit darker, nothing more than trace ever though (it never starts to turn color)...it's just like the test strip gets a little darker, but doesn't change color itself (into a pink or purple) if that makes sense. I don't think ketones are a problem right now. I think it's just his tummy hurting, and so he's not eating quite as much as usual. He will eat the dry without issue. I'll make a trip to the pet store tomorrow to try and find some low carb grain free wet food and see if that helps. I've heard people talk about Weruva (sp?) and I know they have that at my local store, so I was thinking of trying that. I knew things were going too well with him eating wet food.

    I'll definitely have the vet take another look at his teeth at his appointment. When they saw him last month she did look and mention he has some "mild dental disease" but that it wasn't too bad. She didn't really get into it too much at that point, but now that we know about his dx and what not, maybe it's worth looking into seeing if it's something we should/could get fixed. I do have this gut feeling that something else may be going on that's keeping his BG up, whether it's his IBD or his teeth, I don't know, but when he was first diagnosed he was at 420 and now we're at 2.25u of insulin and still these numbers aren't coming down.

    Thanks for the suggestions, and I'll start with an increase in the AM.
     
  64. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    A cat needs the amount of insulin they need. SOme cats go up in dose before they come down so don't despair. You've only been at this for a month so you are still very early in the process. This takes patience and isn't always a totally straight path.
    Weruva is a good food for our sweet ones. Rawz and Hounds and Gatos have unique proteins which could help too. Check the food list HERE for more options.
     
  65. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    He got his increase today, was a weird day with numbers. I did overfeed him a bit, I read up on pancreatitis and got paranoid so I kept feeding him to make sure he wasn't off food (spoiler, he's definitely not). Still refused his wet food tonight, but chowed down on some canned pumpkin once I topped it with dried freeze chicken! So hopefully that helps :)
     
    MrWorfMen's Mom likes this.
  66. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    We decided to switch up Oscar's food, since well we had to, and in hopes it will bring numbers down.
    He's currently back on his old food, Crave (wet, pate), which seemed to always agree with him. He's eating 1 portioned cup before each shot, then at 10:00am/pm he's getting a very small amount of Dr.Elsey's mixed with some Instinct Rawboost Mixer (he's tried it before and loved it, so hoping it can act as a sort of replacement for a portion of the dry). And then for his 1am/1pm snack we're going to try putting a portion of Crave in his timed feeder instead of the Dr.Elsey's. I have a suspicion that the calories in the dry food is hindering his numbers from coming down- so we're going to give this a go and see if it helps bring them down before we need to increase again.
     
  67. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Sounds like a good plan! Good luck! I hope this helps keep the diarrhea at bay and his BG down. Will be watching for an update. :)
     
  68. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Could you take a look at his numbers, Linda? We started last night giving him wet food instead of dry at the 10pm/am mark, and he's been on what I assume, is some dramatic bouncing. Not sure if I should do or change something. He's been up and down by 200 points!
     
  69. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Patience. It can take a few days before the result of withdrawing some of the kibble becomes apparent and you are feding kow carb kibble so the change may not be overtly noticeable. Looks to me like Oscar needs a bit more juice. I'd increase him to 2.5u and if possible try to get some tests in the +5 to +9 timeframe to see what he is doing later in the cycles. Day time is fine but if you get up in the night grab a test then too.
    Looks like he's bouncing from those yellows but that's fine. It's normal. He'll get used to them and stop bouncing quite so much gradually.
     
  70. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thank you for the reminder to be patient, I needed that! I'll start an increase tomorrow am, and I'll get those extra tests in. He has a vet appointment on Tuesday, I'm gonna have them to take blood to make sure there's nothing else keeping his numbers up. I'm also interested in eventually trying lantus, but I read it's recommended to stick with the same insulin for three months.

    By the way, kind of unrelated, but have you ever heard of a cats voice changing, from diabetes or otherwise? Oscar's meow has been..different...and he makes high pitched noises when he eats that he never did before, same with purring. It's really odd, but I couldn't find anything on it when I searched.
     
    MrWorfMen's Mom likes this.
  71. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Can't help with the voice change but our kitties are capable of a pretty good range of sounds so maybe it's just a new one Oscar hasn't shown off before. I have one who literally shrieks on rare occasions when she is playing and it still sends chills up my back and has me running to see if she is OK every time. Maybe the vet can shed some light. Take a recording with you.
     
  72. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I guess it just may be! I had been concerned about a possible upper respiratory infection, and I plan to have the vet make sure on Tuesday, but he's never had one before...and he seems otherwise fine...kitties are so strange sometimes! That's very funny about your kitty, I have another cat (a maine coon) who has a whole range of strange noises...she still meows like a kitten but chirps like a bird when she's excited! Oscar also has a specific meow that we dubbed his "Minnie cat meow" because he only does it after he gets into a fight with his sister, it's like a very loud very dragged out "mrrrraw rar rar rar rar" where he sounds so upset and depressed! He'll walk around doing that while he looks for his sister after he played too rough with her and she got upset and ran away :facepalm:

    I decided to wait for the increase, I think I'm going to start Tuesday. Between work and classes (busy season at work and finals coming up at school) I've barely been able to get in AMPS/PMPS testing and I want to be able to do the appropriate amount of testing when we start his increase. My boyfriend is starting to get the hang of testing though, so that should help me out a ton once he's comfortable enough to do it more often. My lancer broke today, and I learned to do free hand! Irrelevant, I know, but I was super excited once I did it and realized it's so much easier and I can get closer to the edge, thus making it more comfortable for him :)

    And good call about taking a recording! All he does when he's at the vet though is purr (so much so they have trouble hearing his heart beat) and he seems to do it quite a bit when he purrs, so I'm hoping she'll be able to hear it, but I'll be sure to bring a recording just in case. I also read online today that cats with acromegaly sometimes have soft tissue growth in their esophagus, making their meow change...that made me kind of nervous, but hopefully we don't get to that point where I need to worry about him being an acro kitty. I'm hoping numbers start to finally drop for him. :cat:
     
  73. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Yes acro can change a kitty's voice but that's a long shot. Keep us posted on what the vet has to say. :)
     
  74. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Hey Linda, so tomorrow will mark 4 days of the 2.5 dose, with no improvement. Thinking about raising him to 2.75 tomorrow PM. I've been sick and busy the past couple days, so have been getting pretty minimal testing in...do you think there are any tests that would be important to get before increasing? His appointment was rescheduled from Tuesday to tomorrow due to my being sick, so I won't have those results for a couple more days.
     
  75. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Yes it does look like Oscar needs a little more insulin so go ahead and increase when you can monitor a bit between +2 and +6 of the cycle. Hard to see exactly when Oscar is hitting nadir yet.....it seems to possibly be around +3 some days but other days it appears to be later around +5. That may just be because of the testing times and some cats do not always nadir at the same time and sometimes it changes anyway so it makes it hard to suggest exactly when to test. You're getting good testing at night so maybe try to aim for the +4/+5 timeframe for a night or 2 if possible to see if numbers are any lower then.

    Hope you are feeling better now. :)
     
    Chloe007 likes this.
  76. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    We went to the vet today. They didn't want to do blood work yet so soon since it's only been a little over a month and there hasn't been much change in numbers yet. They said he looks good though, and I shouldn't be worried about him having an infection or anything.

    They suggested I go to 3.5u in the AM and keep 2.5u in the PM. That just seems stupid, so I'm going to increase to 2.75 in the AM as we planned and go forward from there.

    They also tried to sell me some Purina prescription food. They told me it was a low carb dry food, and when I asked to see the carbs she turned the bag around and it said 18%, lol. I said he's already on a low carb dry food that is only 4%, and I plan to switch him to wet food only anyways. She had claimed that she thought Oscar had a chance at complete remission with the Purina, suuuch bullshit. So, declined that offer.

    I asked her about switching to Lantus if we didn't see any change in numbers by the end of our second vial of ProZinc. She admitted she knew nothing about switching insulin, or even Lantus for that matter and had to look it up online, and said we should wait 6 months but if I wanted to switch earlier, it's up to me as the owner. I've just been reading a lot about how cats have higher chance at remission with Lantus, but I agreed I should wait to see if we can regulate him at all first with ProZinc.

    He did gain two pounds, from 10 back up to 12 which is close to his healthy pre diabetic weight, so that made me happy. Hopefully that means something is helping?

    The vet was happy to hear about my home testing, which was a nice change from the tech I saw last time who smugly told me I'd be torturing Oscar. So all in all it was a pretty pointless office visit, could have just went over this on the phone..but oh well, at least I was able to see he gained some weight.

    Anywho, just wanted to let you know how it went, and share my frustrations with vets and their crappy prescription food haha. Hope all is well and you enjoy your weekend!

    Oh by the way, his PMPS tonight (directly after we got home from the vet) was 567!!! Talk about stress raising blood sugar...
     
    MrWorfMen's Mom likes this.
  77. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I'm sorry your visit was kind of a wash but knowing OScar is gaining back lost weight is great.

    Giving 2 different doses of insulin AM vs PM only serves to muddy the waters and set off more bouncing when you are trying to get a cat regulated. Looks good on paper but rarely works even in a regulated cat. Good choice to do 2.75u AM/PM. Fingers crossed that helps get his numbers down a bit more.

    I deal with 2 vets I think the world of but the one tried to get me to try some canned alternate protein food for my girl that was WAY over 10% carbs. I just laughed and explained that you can't judge carbs by the label. OH! she exclaimed. Vets get their nutritional education from Purina, Royal Canin etc. and get brain washed into thinking the foods they are peddling are great. Purina DM dry isn't diabetic food.....it's dietetic food.....for weight loss. Most cats don't lose weight on it and most diabetic cats have already lost weight and don't need to lose more so how they came to the conclusion that was good food for a diabetic is anybody's guess. You really have to wonder how they can get snowed by the big pet food companies but they do. :rolleyes:
     
    Si am cat mom and Chloe007 like this.
  78. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom

    Quick question for you...this morning when I was preparing Oscar's shot, I noticed there were a couple tiny bubbles in our vial. After rolling it gently, they would go away for a moment before reappearing, or they would show back up as I was pulling the insulin up into the syringe. I managed to pull the insulin into the syringe with just the tiniest air bubble near the bottom, and figured it wasn't worth wasting the insulin over..wasn't big enough to mess with my measurement. But I'm wondering now, was that okay to do, as long as I'm getting the correct dose? I mean, it's not like we're injecting into the blood stream...a little bubble should be fine, right? I once accidentally injected an empty syringe of air into Oscar when I first started (was really tired, don't ask) and he was fine...so I think I'm overthinking this air bubble thing, but just wanted to be sure. Also, does this indicate my Prozinc might be going bad? Should I start a new vial? I still have about half of this one left.
     
  79. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    A tiny air bubble in the vial is not a big problem and doesn't indicate there is anything wrong with the insulin but if you get a lot of bubbles in the insulin, it could start effecting the insulin eventually. Any air in the insulin itself should eventually rise and join the rest of the air in the vial. The same is true for the syringe. You sometimes get pesky bubbles and best to try to clear as much as you can by holding the syringe needle end up and tapping the barrel to encourage the bubbles to the top, drawing back on the plunger and then squeezing them out. A teensy little bubble or 2 won't make a big difference but too many or a big bubble could actually effect the dose more than you think. While the odd bubble isn't dangerous with SubQ shots, I'd still try to get rid of as many bubbles as possible.
     
    Chloe007 likes this.
  80. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thanks, I've been careful about not allowing bubbles for measurement accuracy. This all started after I shot insulin back into the vial, so now when I get a bubble I can't get out, I just shoot into the sink and do it again until I get it right. I've gotten better at flicking the bubble out, and the bubbles do seem to be lessening in the insulin itself, just a few hanging out at the neck of the bottle. My main fear is that if it's losing it's effect and I keep going up in dose, when I do start a new vial, he could seriously drop. There's been nothing happening yet to indicate its losing it's effect, numbers haven't been getting worse (except for that day at the vet) and I'd go as far as to say they're looking a tad bit better. Not nearly where we need to be, but I took a +8 today and while he's normally in the 400's by this time before dropping a bit at PMPS, he's at 301. So hopefully that's an issue yet. I'd like to go up to 3u on Wednesday night since that's my night off if numbers don't change much by then.
     
  81. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    If numbers stay in same range as now then by all means increase to 3u on Wednesday.

    When you get a new vial, it's always a good idea to monitor the first cycle whether you suspect your old one was losing efficacy or not. A day at the vet doesn't count as worse numbers.....just a stressed out puddy tat! :)
     
    Chloe007 likes this.
  82. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Maybe not so soon! We had our first yellow preshot today! I'm nervous because I won't be home to test him until +8, but I have someone keeping an eye on him. His +1 was 243. I have a feeling he will drop into blue at some point today and I won't be there to catch it! Grrr.
     
  83. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Our kitties just have the best timing NOT! Leave Oscar some food even a bit of MC to eat in your absence if you are concerned. He will be fine.
     
  84. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Thank you! I did put a bit of extra dry food in his feeder just in case, and when I got home, it was all gone. Can't say for sure his sister's didn't help with eating it, but they don't usually eat dry. That plus the fact he's now 331 @ +7, makes me feel like maybe he did drop a bit lower than he's used to, and when that happens he eats a ton, and now that's why he's already high again. Hoping we don't see a bounce :)
     
  85. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Bounces are frustrating but they come with the territory and when you can't be there safety has to trump letting kitty go too low. Maybe he did eat all the food recently enough that it's reflecting in his numbers right now. Only time will tell.
     
  86. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Hey Linda! So he didn't seem to bounce yesterday, but he did go back to his normal numbers, and AMPS today was back in the mid 300's. I have tomorrow off, and was planning tonight to do his increase...but with his lower AMPS yesterday, I wasn't sure if I should let him ride out a little longer on this dose. Wondering what you think! I probably won't be able to increase until sometime next week if I don't do it tonight/tomorrow.
     
  87. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I'd increase now while you can monitor. While that AMPS yesterday was lower, it wasn't hugely different so I don't think that should factor into your decision to increase now. Better to stay on top of numbers and if you can monitor, you can keep Oscar safe even if he did decide to surprise you! :)
     
  88. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    That's what I was thinking, thank you! The increase was inevitable anyways, so makes sense. Not sure why, but I have really high hopes for this increase... haven't had this feeling with any other increase so far so really hoping my gut is right this time!
     
  89. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I'll keep my fingers crossed your intuition is right!;)
     
  90. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom

    I have had a couple crazy days, haven't been able to test as much as I'd like and couldn't get a PMPS last night as I was at work and my boyfriend couldn't get the meter to work. When I got home at +7, he was at 280. And since then, his numbers have gone downhill quick, he's been in the 400's all day. Any suggestions?
     
  91. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    It's really impossible to say what happened there but it does look like numbers are starting to settle a bit again now. It's possible that BG dropped lower sometime before that 280 at +7 and Oscar was on his way back up at that point, causing a bounce to higher numbers the following morning. The only other tangible would be if Oscar got into some contraband he shouldn't have. I can appreciate having meter issues is a problem but this is a prime example of how important it is to know where the cycle is starting to be able to make sense out of the readings that follow. In case a situation like that pops up again, maybe keep a vial of AT2 strips around and in the event that the Prime isn't working for BF, he can use the AT2 as a backup. You can keep a note in remarks that the pet meter was used but it would at least let you know it was safe to give insulin.

    All that said, I don't think Oscar dropped into any dangerously low numbers and it really looks like it's time to up his dose to 3.25u to see if you can't get his numbers down a bit more.
     
    Chloe007 likes this.
  92. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    I upped his dose the night after you suggested, still high (if not higher) preshot numbers but I caught a blue just now at +3 after his PM shot.
     
    MrWorfMen's Mom likes this.
  93. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom

    Do you think I should do another increase tomorrow PM, or give this dose a little longer? Just thinking, after tomorrow afternoon I'm off until Sunday...so if I were going to increase I'd like to do it sometime this weekend.

    I'm having an issue lately (just temporary) where because of my work/school commitments, he's often times getting a shot 13 hours apart instead of 12, I could work it out to where it could be 11 hours apart- but unsure if that's safe. In a couple weeks, we should be able to get back on a 12 hour schedule.

    I'm also trying to figure out a better feeding schedule for him, as I don't think this one is working very efficiently anymore. Actually, his blue last night I think was highly influenced by me forgetting to give him his +2 dry snack. So I'm wondering if he's eating too much too soon after his shot (which is hard right now because his appetite is still out of control, and I fear restricting too much because I know food is important to keep DKA away). He gets a snack at +2 and +4, and by the time I'm home at +7 he's finished whatever dry was in his bowl and is acting like a crazy person because of how hungry he is. Same thing in the PM, by around +9 he's acting crazy trying to wake me up to get him more food. Maybe switch it up to +3 and +5? What do you think?
     
    Last edited: Dec 19, 2019
  94. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Yes I think another increase is needed. Oscar only saw blue once on this dose and seems to be back to higher numbers. .
     
  95. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Right as you replied I added an edit about his shot schedule, and feeding schedule, was wondering if you had any advice on that. Sorry, didn't think I'd get a reply so quickly! And sounds good, I'll raise him tomorrow PM to 3.5u :)
     
  96. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    How about increasing his portions a wee bit at meal & snack time. Diabetics can't properly process the food they eat so they need more than usual. As Oscar gets more regulated you can back off on the amount again but for now don't be afraid to feed him more to keep him more satisfied. Feeding times are really a bit of an experiment so you could try increasing pre-shot meal amount and move the next snack to +3 and see how it works.
     
  97. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    @MrWorfMen's Mom

    Hey Linda, so as you know we've had a crazy past couple days. I didn't get in nearly as much testing as I'd like, and tbh I didn't even really get a chance to input or look at Oscar's numbers until now. He's running really high. He's been stressed with everything, sounds silly I know, but he's strangely very sensitive. The night his sister was away (her name is Chloe, but to avoid confusion I just try to say "his sister" since we share the same name lol) he sauntered around the hallways crying all night, wasn't eating etc. He did that until she came home, and he became unusually difficult with testing...so small chance those numbers are slightly stress influenced. We picked up a new bottle of ProZinc yesterday but I'm not starting it until tonight so I can monitor. His old vial was starting to look a little funky...clumpy almost, and by yesterday it wouldn't separate anymore. I would take it out and it looked like it was shaken. I suspect the new vial may help considering that, maybe not, but I was thinking...let's see how tonight goes with the new vial and raise him to 3.75 tomorrow if still running high? I'll keep the old vial in the fridge in case of absolute emergency but I do think it went bad..sucks I still had nearly half a bottle.

    I should also mention contraband food may have been a factor. In the midst of frantically trying to get his sister to eat before we took her in, it's likely some HC food was left lying around for hours while we were gone with her. Unfortunately, Oscar was kind of on the back burner the past couple days but I plan to get him back on track now.
     
  98. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    If the ProZinc is looking "funky", not separating, clumpy, then it's no good and that might be why Oscar's numbers have been high. I'd hold off with the increase until you get a couple of doses in him from the new vial as having good insulin may make a big difference. Monitor him when you start the new vial.
    It's possible some of the high numbers are also stress from Chloe being gone and perhaps contraband but I'd still keep a close eye on things.
     
  99. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    Hi Linda, hope you had a nice Christmas and you're doing well! Things are finally starting to settle over here (Chloe the cat is doing much better and recovering well). Oscar's numbers should be true (not influenced by HC or stress) and I think I have enough data now to know that the old insulin likely wasn't the leading issue with his numbers. I made the decision on my own to raise his dose on 12/25 to 3.75 and we're still looking high. Wondering if it is still too early to raise him to 4u? I'll be home this weekend to monitor him, I'm feeling anxious and wanting to get him to better numbers so if you think it's okay, I wanted to increase tonight.
     
  100. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Had a nice peaceful quiet Xmas and was partying yesterday and later today. How was your holiday?

    Yes it looks like Oscar needs an increase so take him up to 4.0u starting tonight and see if that makes a difference over the next few days.
     

Share This Page