elvis thursday

last nite scared me ...i did check his sugar but forgot to put in on the chart...i did this today...we tested him at 10 p, his sugar was 75...i thibk it was the friskies tuna that got hom so low...i am going going to the vet friday...
i am going to talk to her about lowering the dose of novolin...this am his bg was 470....i am afraid to lower the dose since he is starting off so high...

 

my husband and i will lower his dose tonoite...we do not want to do it during the day due to no oine is home and no one can come and check him for us...

 

We are concerned that the reason he is going so high in the morning is that he is so low during the day. It's that rebound thing: http://petdiabetes.wikia.com/wiki/Somogyi_rebound If you are going to give the larger dose, please have food out during the day so if he goes low, he can eat and hopefully bring himself back up. I know it sounds safer to give more insulin, but in your case, it is not. The mantra here is Better too high for a day than too low for a minute.

Is there any chance you or your husband could check on him sometime during the day?

 

Please tell me that you did not give 3 units again today? Have you not read what people have told you in your previous posts?

 

you are reacting to each number and that's not what you should do with this disease. that puts cats at risk when people do that.

you see a higher number, you shoot more. you see a lower number, you use syrup.

boing boing boing.

that is what Duke's body is doing.

the high number this morning is due to the low numbers last night. it's called rebound, or in other words, the result of his body going WHOOOOOOOOOOOAAAAAAAAAAAAAAAAAAA when it felt that 40 something number last night and throwing out everything it had to save itself. that combined with the insulin type you are using is commonplace when kitty is being overdosed.

please listen to the people here. there are years and years of experience here with this disease and believe me, i swear on my father's grave, no one here is going to tell you something that will harm your cat.

 

If I was you and Elvis was my Spot, I would not be giving the whole 3u. I believe that a few days ago, it was suggested that you drop the dose down. It does sound like Elvis is in rebound, which happens when the kitty goes to to low, and Elvis is more than likely going to low during the day.

In my opinion, if you really want to help Elvis, you would do a better job if you listened to the folks on the board. I'm not sure about the vets in your area, but most vets do not have the extensive experience in Feline Diabetes that the folks on the board do. Yes, it is hard to put your faith and trust in folks you have never met...and have only met on a message board on the computer...I can assure you that there are quite a few folks who felt that way, including myself. I stuck by my vet for a while, and Spot did not get any better. I started to follow the direction of the more experienced folks on the board and became friends with them...and found folks in the Pittsburgh area who were available for one on one support. They suggested that I switch from Humulin N to Lev and here Spot is, Of the Juice now and doing fantastic.

Keeping you and Elvis in my thoughts.

 

The only reason he is so high this morning is because he didn't get a shot last night because he was so low.

To stop this rollercoaster, you need to reduce the dose so that he can safely get two shots per day.

I would try 2 units since 3u was too much.

A longer lasting insulin would also help -- starting over at 1 unit BID and working up to the ideal dose, which may be around 2 units or so.

 

i did give elvis his shot last nite but again could the food i gave him be the cause of his bg going so low???? the food had 3 carbs and i gave him 3 units due to when i tested him his bg was 470... i always get high nu,bers when i test him before the injection...
i have never seen a number lower than 450 for 2 weeks now before injections...i guess i am looking at this wrong..i see a high number and i see with 3 units his bg does lower to 80-100 after 4-5 hours (exception of last nite) so i think this is right...also i have been testing him after he eats and minutes before his injection..(feeding him at 5 testing at 5:55 injection at 6) is this too soon ..to late..?? please i am really not trying to get people angry i just want to get this right...

 

It is a hard concept to get your head around. In the morning he is high, so you give him what we think is too much insulin. His body goes low and then reacts to the "overdose" of insulin by dumping glucose into his blood. This raises the bg level. With shorter acting insulins like N, you get this pattern of alternating highs and lows when you are giving too much insulin.

It is not the flavors of food that are lowering his numbers. It is the insulin.

We are very concerned that he is continually going low. That is much more dangerous than being high for a while. No one is angry. We are just worried. We have seen this happen before with tragic results. If he were my cat, I would find some way to get someone over there at +4 or so to check on him. And I would lower the insulin dose.

 

but when i check him at nite (feeding at 5 pm testing at 5:55 pm) i get the around the same number as the morning always 450 to 470...
so lowering the dose of insulin will stabalize more evenly??? i thought the goal to give insulin to lower the bg...
in the am and pm his numbers come down over time usually after 3 to 5 hours his number is low and slowly raises...i really thought this is how the insulin was to work...so when i check him tonite after i feed him i will bet you his bg will be 450 to 470...the trick is lower unit of insulin ...see when he was addmitted to the vets 3 weeks ago..hig bg was 490 and i didnt think he was goning to make it...

 

the food isn't the reason for the low numbers last night. you WANT to feed an appropriate diet for a diabetic and that is what you did.

but you have to work the insulin with the appropriate diet. soooooooooo, the appropriate diet combined WITH too much insulin is what caused the lower numbers last night.

and the high numbers you get when you test him before injection are because he's going high low high low high low. he needs to even out. numbers before injection aren't the most important numbers all the time. the numbers in the middle fill in a big part of the puzzle.

yes, the goal is to get lower normal numbers but 400--80--400-80--400 will keep you on 400-80--400--80. that big drop from 400 to 80 is what's causing the 400 the next time. in other words, he's staying on the roller coaster and never getting a chance to get off it.

and yes, testing him AFTER he eats, especially nearly an hour after he eats is wrong. the food causes the glucose levels to spike so you are seeing a falsely elevated number. test him first, say at 5:00, then feed him, wait 1/2 an hour or so and give him his shot. with the insulin you are using, that is the way it should be done.

don't worry. i'll admit, we do get frustrated. because we get so worried about the cats. so if we come across as angry just know that it is because we are scared too. scared for the cats involved. (((hugs))) so be patient with us and we will be patient with you while we help you

now as an example of what i was talking about just above i'll use my cat.

when she was on PZI, i could test her before meal and get a 150. which would make me shoot 1 unit of her insulin. she used to get such a big food spike that if i fed her first and then tested her, i could easily get a 250. if i panicked at the number and shot more insulin, let's say 2 units, then in an hour or so as that food spike wore off and as the insulin started working, she basically would or could go thru an overdose, dropping let's say into the 30's wherein i would have to intervene with syrup and stay up all night making myself exhausted and perforating her ear all night making her pissed at me.

but, if i stuck with the 1 unit because i know she got a food spike, she might have dropped comfortably into the 80's let's say and her and i would have a nice quiet smooth evening

if we respond with panic to each number, we can very easily kill our cats. the goal is to avoid that.

 

Carous said.....but when i check him at nite (feeding at 5 pm testing at 5:55 pm) i get the around the same number as the morning always 450 to 470...
so lowering the dose of insulin will stabalize more evenly??? i thought the goal to give insulin to lower the bg...
in the am and pm his numbers come down over time usually after 3 to 5 hours his number is low and slowly raises...i really thought this is how the insulin was to work...so when i check him tonite after i feed him i will bet you his bg will be 450 to 470...the trick is lower unit of insulin ...see when he was addmitted to the vets 3 weeks ago..hig bg was 490 and i didnt think he was goning to make it...

Yes, because both in the am and the pm he is rebounding from a low number because of too much insulin. He is probably low at night in the middle of the cycle also. Yes, the insulin is working to lower his bg level, but too well. It is taking him into numbers that are uncomfortably low for his body so it is reacting. Less insulin will still work, but not make his go too low.

490 is a common value for new diabetics. It is a high number but not unusual. We see cats in the 500- 600 range. That is pretty high. We want to bring the numbers down. We are just urging you to do it safely.

 

cindy
i just called my husband and he wanted me to ask you this...
if i test elvis at 5 pm and his number is 450-470 and i feed him (which elvis does have a problem eating in 1/2 hour he usually eats a little leaves comes back eats a little more leaves etc which is why i was waiting to give him his shot for a hour...) will 2 units be enough to get his sugar down or level him out for awhile...i cannot get anyone to check him from 7 to 4 pm there is no way i can leave work or my husband ..so when i get home from work the insulin from this am shoould be "out of his system" so i will check his bg...for the last week we do see the bg go from 450 to 300 to 200 to 150 to 80 then start to rise and this is not the way it should be....over a period of 8-10 hpurs is the roller coaster...but if this is what we see with 3 untis...wont 2 units not make the bg come down as lo?? am i saying this right??

 

there is a saying that goes something like "too much of something is not always a good thing"

what we see here ALOT is too much insulin being given. cats go to the vet. they get diagnosed. the vet keeps the cat for several days to "regulate" them. all the while kitty is sad, stressed out, uncooperative, and usually not eating or going the bathroom normally. this all causes higher glucose levels and since the vet's office tests them twice that day, maybe a couple more times, they just keep shooting more and more insulin into the cat. the cat goes home wherein he relaxes but he's still getting that big dose of insulin and kitty ends up crashing and being rushed to the ER or dying at home in the midst of seizures.

so see, more is not always the answer.

as an example i'll use ourselves. when Mousie & I started this dance, we did what's called the Hodgkins Protocol. that is a protocol designed with one insulin in mind, PZI. the way it works is you test like crazy and shoot as much as 3 or 4 times a day and shoot a fluctuating dose based on the glucose levels you got every 6-7 hours. so if you got numbers lets say 150-200 you might shoot 1/2 a unit of PZI but if you get a number of 300, you might shoot 2 or 3 units of insulin.

and over the years, for those at home all the time or whatever, that worked well for hundreds of kitties. for us though, and plenty of others too, shooting more insulin caused Mousie to stay high. it took me quite a while to figure out that 1/2 to 1 unit of insulin twice a day worked better for her and she stayed in numbers roughly between 80 and 200 most of the time. a much happier healthier kitty too.

make sense?

or how about this. we humans get a headache. we take ONE maybe TWO aspirin. in a few hours we feel pretty good. but let's say we had a really bad headache. would you take 20 aspirin based on the severity of the headache? nope. why? because we'd end up feeling like crap and probably would end up in the ER from an overdose.

 

in other words slow and steady..not fast and hard....ok i get home from work at 4:30 and need to have my husband read all this he is just and confused as i am

 

at 5 pm elvis bg was 488 he is eating now...

 

OK, I am late to this posting. I posted on the other thread. Anyways, I really feel that you need to switch to a different insulin. Did your Vet tell you about ProZinc? or LANTUS, LEVEMIR? It really looks like you need a longer type of insulin. Being that you and DH are not home during the weekday to test. You need to go lower for risk of Elvis going Hypo. Just remember when switching to lc food. You really need to be around to check bg's if your at a higher dose. I have not read all the reply threads, but I'll be back to check in on you guys.


Trying to find out if anyone suggested going 1.0U? Let me check.

Did you read these?

http://www.catinfo.org/felinediabetes.htm

http://felinediabetes.com/hypogly.htm

http://www.yourdiabeticcat.com/protocol.html

[/quote]

 

Quesion - Looking at Elvis SS. You have PMPS 488 right now? You have on the msg board posting that was at 5pm. Is your AMPS at 5am? these need to be 12 hours apart, ok.

 

the vet just called back she said to lower the dose to 2 units and keep an eye in elvis...my husband and i are just concerned 'cause we know his bg should be 80 to 100....he keeps asking me is it still good if we give 2 units and his bg does not get that low....is it more harmfull to let him peak at 200 and not reach 80,,,the vet also said she is looking into geting PZI...so which is better getting down to normal or being higher please let me know

 

I will try to simplify this

If you overdose, the body will try to compensate and you will see higher numbers especially at preshot time. Eventually the body can't compensate and the cat crashes.

Right now you are seeing big swings in bgs; likely due to the rebound effect that I've described above; even if it isn't rebound it is a horrible rollercoaster for your cat and will make him feel like sh*t.

Cutting the dose will help you see whether things improve or not.

A non diabetic runs under 120; with a cat on insulin, you need to be more cautious as you do not want to bring those numbers too low and you have to work slowly towards nondiabetic numbers.

You and your husband need patience. You need to approach this like a science experiment and make methodical choices and not over react.

Yes, PZI or lantus or levemir are much better choices for a cat, but right here and now you have N and you need to try and work with it.

I hope this helps. I know you guys are trying but you have to slow down.

 

I would suggest 1U, but that's me. There is definitely overlap in his system, Yes, keep an eye on Elvis tonight. As far as Elvis being in the 80 to 100 range. That is not going to happen over night. Please know that this is a SLOW process and needs to be taking that way. If you start rushing things - you will only get a headache trying to figure out what went wrong... why his numbers are all over the place etc. You want his to bring his BG'as down slowing or you're just putting him through a roller coaster ride which is harmful for his liver etc.

Switching to a different insulin should be done ASAP. Don't wait another week, ok. Even when you switch to a different insulin.. it will take a few weeks before you'll start to see the numbers you want. We'll go over that later. I just want to send this to you so you can read it.

Forgot to mention - Very important - Log everything you do. Keep SS up to date will also help us help you. ;-) You will want to go back and remember what had been done etc, so log it! I'll check back in a few hours.

 

i am so sorry...i have a headache over this but what does ss mean?

 

Hey, First of all this is for you :YMHUG: Everything will work out :smile: SS = spreadsheet!


If you look at Pru's SS you will see that I've logged everything. Even the effect that certain food had etc. Now, I went TID (shot 3xs day) but only because I was able to be home with her. You need to be able to test more during TID. Anyway, If you decide to stay with your current insulin, that's up to you. I am curious how much Elvis weighs? Pru is a small kiity. Her weight is 8.5lbs. Starting her off with 1U worked until had to decrease her doses.

 

this is how we found out elvis had diabetes...he was loosing so much weight and eating like crazy...before he was about 15 to 17 lbs....when e took him to the vet he weight 10 lbs..then lost 1 more when we had to admit him...i dont have a scale to weight him...waiting for my neighbor to comehome to borrow hers...

 

Well, when you get a chance to get his weight. Just hold him then subtract your weight. ;-) I would also keep food out all the time. Just add some water to it. That helps keep it from drying out. Sometimes they like it a little wet so they can lap it up. Plus this helps keep them hydrated. Since we're kind of starting over, I will tell you this - there will be some wonky numbers, so just breathe ;-) You'll get through this. I know its alot to take in, but you will get the hang of it. What foods are you feeding? I know you had mentioned Friskies, but is there anything else we should know? I would also only give the treats during shot time/bg test times.. at least for now. (if you are giving treats - make sure they are the freeze dried treats)

Need this answered - Did you shoot 2.0U at 5pm while he was at 488? Please keep his shoot times 12 hours apart. If you haven't been.. we need to consider more overlap in his system. Very important - this whole process you need to be consistent with everything as much as you can. It's the only way to pin-point what to do next.

Also make note that Elvis can go lower at +3 or +5...even +8ish. I am just concerned that you seem to always test at +4, so that's why I am bringing this up. I will be out tonight, but I will check back before I leave for the night. I will also check in after I get home which will be about 3am your time. Hang in there!!! Hugs to Elvis cat_pet_icon

 

i test him at 5 am and 5 pm then he gets fed...he gets injected at 6 am and 6 pm...i have friskes and 9 lives here right now...you said to leave food out but i read somewhere not to...we never had a "feeding time " for any our our fur kids (one other cat halle and a dog poker) we always let food out and they would graze...if i can let food out especially at nite this would help...he is starving about 4 am and is "yelling" at me

 

the food situation has a fine line, but right now, you need to keep food out for Elvis. i can explain the food later... i just don't want to throw too much at you right now. what's important, is that Elvis get's food if he needs it. Is there anyway he's getting into the other furbabies foods? if he is... this could be causing your high numbers too!

I have 5 cats. I just want to give you an idea what I do -

I split up two 5oz cans between 5 bowls or 3 to 4 3oz depending what brand I am feeding. I put food down again about every 5 hours. (give or take an hour here or there) The seafood type of foods I try not to let it stay out too long. So, tomorrow morning I'd leave enough food out for Elvis and water it down to keep from drying out during the day while you're at work.

Note in Elvis's spreadsheet how he's feeling, what you fed, did he eat right away, is he sleeping a lot, how many tries did it take to get bg's... whatever you notice about him... anything, so we have an idea what's going on, ok ?

I'll check back late tonight and in the morning.

 

i am going to check him about 9:30 cause i am so tired.....i will leave out a little food tonite for him...we pick up pokers and halles food unless we are feeding elvis...there are 2 water bowls since it has been so hot here the last few days....thanks for all the help and support and patience....

 

tested elvis at 9"10 3 hours after ibjectiob of 2 ubit his bg was 94...i think i am going to split the food from the day and feed more often..he seems hungary think i will be up early again tom...

 

see, you reduced the dose and still get quite a drop. kinda puts into perspective the less is more thing a bit?

because he still went from high 400's down into double digits you very well could get another high number in the morning. it is to be expected when they drop so much. so don't feel defeated in the morning if you do k i'm on the west coast so won't be up in the morning when you do your morning test though

i have a feeling you'll be cutting that dose even more soon

 

I am walking out the door, but just saw your post. please try to test at +4 +5. the 94 at +3 means he's still dropping. remember, there is overlap of insulin in his body. that 2.0U you need to watch. thinking of you guys tonight!!!! i'd make sure he's raising b4 you go to bed. if you give him high carb food to keep his bg's from droppng, please know that you still need to test cause it will give you a higher reading, but that doesnt mean he's still not going to drop again. if you need help while im out. please post another post with help! in the subject line. go to the PZI group too. there are alot of folks on there that are up late.

 

were you able to get bg at +4 & +5? i would go to 1.25U in the morning since you wont' be home to test.