Duke 6/10

Thank you all the advice and feedback. As usual, I have more questions than answers.

AMPS 323 1.5 u
+ 7 = 273

PMPS 349 1.5 u

Spreadsheet updated.

Numbers look better today.

I can't imagine these numbers smoothing out too much since my feeding times and caloric intake vary from day to day. The real question here is whether or not Duke is able to put and keep on weight.

Duke looks great. My Wife came back from a business trip and commented how bright his eyes look.
He's eating well. Getting plenty of fluids.
Last night he was snuggling and grooming with his sis.

I kept the dose at 1.5 units. With the syringes I have, there is no way I can increase by .25 u with any kind of precision or accuracy. Oddly, the ketone smell is one that I'm used too from lab work. My nose is pretty sensitive to it. I could smell it when he was at the vets early on in his dx when others couldn't. He is peeing normally which is a good sign and his hydration is good.

Thinking aloud: Why not have the pharmacy compound the PZI at u200? Then each mark on a u100 syringe would be 0.5 units. I'll also run this past my vet tomorrow.

Scruff shots: We give the shots at the top of the flank. When first diagnosed, we were giving shots in the ruff. No one told us not to, and it is by far the easiest place to do so. We stopped this long ago when I read this is not the way to go. I'm surprised the vet never told us this was not the place to to give shots or oddly expressly told us where to give the shots when we first embarked on this strange journey. Anyway, more water under the bridge.

Found freeze dried anchovies at Walmart. Duke nibbled once. The others looked at me as if I was crazy giving them that stuff to eat. Maybe it's an acquired taste or as my wife pointed out, she doesn't like anchovies either so ..........

Curious to see what +5 looks like.

BD

 

At least we got a drop today - that's progress

 

Do you mean compounded at U50? Wouldn't U200 be 2x as strong as U100 and therefore one mark on the syringe would be double the insulin? My head tends to swim with this stuff. Since many of us use U40 insulin with U100 syringes, if you could get them to compound it as U40, you could use the same conversion chart & stuff others use. In the U100 syringes and the U40 insulin, one 1/2 unit marking is 0.2u (or 1 regular mark = 0.4u, though I love the 1/2 unit syringes). Do you have 1/2u syringes? With those you can guesstimate 1/2 way between the mark - I do that a lot. It's not 100% accurate, but as long as you are consistent in how you measure, for me it has worked (but I use U40 insulin, so perhaps that changes things).

That's great that he is looking so much better, that must be a huge relief for you, and is definitely a good sign. I would still increase the dose a hair though, since his #s are still fairly high. You saw a nice U-curve today which does not suggest rebound, so I don't see any reason to hold back on more insulin. Of course there is always a risk of low #s/hypo, but if you are monitoring in the nadir zone and he is eating when he wants to I think it's unlikely, and the ketone cloud seems to me the one that looms larger. Just my 2c, of course you need to do what seems right to you.

 

Yup, more insulin. Try to keep below 200 at all times, grazing around 70-90 at lowest point. Numbers above 250 tend to be unstable and less predictable anyway on some cats, so puzzling about small rises and dips is unproductive. Just try to give enough insulin to stay below 200.

Especially if you're smelling ketone breath!

Best,
Steve