Frank, the 2nd chapter

I was so busy all weekend....and ran out of relion strips. So I was sporadic in my testing, and Sun morning fell to my mom for the shot...and she only gave 2U because she's not comfortable with BG testing. So, the no shot morning and lower dose at the end of last week, followed by a low dose on Sunday AM,...well, we saw some high numbers. (I know, I need to update my spreadsheet.) Buuttt....a slightly increased dose this evening and we are looking good. Going to be strict with testing the next few days, but I'm hoping 3.75 is our magic number.

 

Was wondering where you were over the weekend

 

Nice to see you back! And glad you're getting some good numbers this evening!

 

The weather here was GREAT, I was so busy all over the place, trying to enjoy the outside and get things done inside, then Easter...whew. Plus I'm STILL fighting this darn cold!!!! All that and I just wasn't a good diabetic cat mom this weekend. I'm somewhat ashamed of my intermittent testing, lol. And tonight my 2 new hives of honey bees came in, so that was time consuming as well. I'll do better this week. Poor Frank's sugar has been all over because of my hit or miss care.

 

Also...I'm so jealous of @Stressedcatmom numbers. Yoshi is looking great! And the Chloe thing stresses me out. Like, majorly stresses me out. I think I just need to avoid that thread. I think I'm going to grab one more test on Frank and call it a night

 

I know you didn't get AMPS and PMPS over the weekend, did Frank actually miss 4 of his shots too? You make honey ? I would love to find some local honey.

 

I've read about the environmental stresses on honey bees. Is it hard to keep them healthy?

 

Not really. It's hard to not get stung, lol. We did lose our queen at the end if last year, so the hive died. Starting over this year with 2 hives.

 

No, he got his shots and most of his amps and pmps. I just haven't put them on the sheet because I'm a slacker.
I don't make the honey...I just steal it from the bees. Last year was our first year. When we started harvesting, I bought a gallon of vanilla ice cream and some local blueberries and strawberries....and made the best sundaes ever.

 

My little side business....

 

Yum!!

 

Wow! I've always wanted to have beehives...is it hard?

 

It's not hard. It can be expensive, and does require some work. But for the most part the bees do their thing, and you just watch them. They were stirred up this afternoon, though.

 

OMG...I'm terrified of bees. Just looking at that pictures is stressing me out. But honey on the other hand....mmmmmm.....yummy!

 

Very cool! I love bees! I have lots of flowers, both wild and cultivated and lots of wild honeybees around as well as other types. Love chickens too! I have 12, but plan to add lots more....

 

Fingers crossed for all the kitties!

 

Can I buy any of those suckers to do my preshot tests for me?

 

Ooohhhhh.....yes. FINALLY!!!!

 

Hurray for green!!

 

Wooohooooo!!!! Go Frank!

 

WOOT!!!

 

Well he ate his entire nighttime food after that green (3/4 of a can) and I got the 108 about 45 minutes after that. I'm pretty sure he's hit his nadir, but I did give him about 1/8 c of his dry RC just to safely get him through the night. (It's 12:30 and I have to get to bed!) He's so loveable right now. I wonder if it's because he's feeling better.

 

Fingers crossed for good numbers tomorrow...and guidance in dosing.

 

Lovely green! You know we're always here to provide whatever advice we have Sarah...and remember your instincts are great too!

 

I got a nice big bounce number this morning instead of a good number. Going to hold this dose steady at least until the end of the week to see what happens, unless I get a NS number.

 

Not surprising at all. You'll get past it. He's a bouncer and this is what they do so take it in stride.

 

Whoa....Frank has an extra bouncy trampoline this morning! I'm curious to see where he lands as the bounce settles out.

 

Yay!

 

Grats on that first green!

 

Well, tonight's numbers are quite a bit better!

 

I hope I didn't over shoot on a low number. Eek. That's the first yellow on a PMPS...and I'm still testing with the AT2 which reads higher than the relion..

 

What dose did you give?

 

3.75 I just realized I didn't put it on the sheet. But ughhh. Lower doses don't do anything, so....fingers crossed and a possible long night of monitoring ahead.

 

My bet is that he'll be fine...but getting a test or two in before bed is always a good idea with 'new' numbers!

 

Finally got strips for the Relion again. I don't like those high numbers on the AT2! However, that brings me to my next question....Frank was hardly ever black on lower doses. Is it possible, with his tendency to bounce, that I missed his good dose and now he's over compensating by bouncing higher? Or should I try another increase? He was so much better on 2.5/3 than he is on 3.5/3.75. I know the AT2 reads higher, and that's part of the reason for the blacks recently, but even on the Relion he'd have been higher than usual. As always, I'm super grateful for the expert advise on this board!!

 

Ummm.....I don't know?

Not very helpful, huh? I'm going to think 'outloud' for a second....I think if it was me, I'd give it a couple of cycles back on the Relion. You can't compare numbers between AT2 and a human meter, so it's hard to know how to consider the AT2 numbers in relation to the surrounding Relion numbers. He does seem to be bouncing around a fair amount in the past week, which could be too high of a dose, something has changed, or you're at a better dose and he just needs time to settle into the dose. But you did get a nice cluster of blues and greens during the PM cycle at 3.75, which leads me to think that the dose isn't too high. There aren't any AM mid-cycles numbers at this dose, so it's hard to know about that part of the cycle. He might be getting nice numbers there, but we just can't see them. Or maybe not.

You're doing a good job of keeping the dose consistent right now, so I think after all of that rambling, I'd go back to the first thought - hold steady at least through tomorrow, get some AM mid-cycles on the Relion, and then maybe look at a possible dose change on Sunday or next week. His pre-shots were more stable at the lower dose, but his nadirs were too high. You're starting to see some better nadirs now, so I don't think the dose is too high.

I'm curious to see what everyone else thinks about this though...

 

You did get some nice numbers on those lower doses, but they were really just nice in comparison to what you're getting now. You were still sitting in yellows most of the day...which isn't what you want. Considering that you've increased slowly and consistently and gotten some nice blues and greens in there, my thought is that it's a combo of using the AT2 vs the relion which shows higher numbers and possibly a bit of insulin resistance. Even with those nicer numbers from before, he was sitting too high and getting some pinks preshot which is why I think that. I tend to think that the slow, steady increases are still best to hopefully help break through that and get him in nicer numbers.

I do agree that maybe you want to use the relion a few days (or use both if you prefer) so you can get a better idea of where is from that meter since you have info on that from before.

 

Day testing is hard (work...what a drag!) and tomorrow I'm gone for the better part of the day, so I guess we'll hold steady at 3.75 and get some day numbers on Sunday. Who knows, by then maybe his bounciness will go away and I'll be back in those yellows and maybe some greens. I guess I should have waited until Sunday to ask these questions. The good news is that even with me limiting his food to 2 cans a day, he's not losing weight again, so something is working right for him. Poor guy was SO SKINNY when he went to the vet just a month ago. I feel terrible that I didn't catch this sooner!!

 

Right?! If only we didn't have to work! I'm pretty lucky to get to work from home a couple of hours most days, or swing by between appointments when they're close by. I think it's always better to ask questions ahead of time, since there isn't always someone around at the last minute.

Is he supposed to be gaining weight? Or is he at an okay weight now? Maybe you can have some of Sam's weight...he's not excessively overweight, but he could stand to lose another pound or two.

 

My two cents: stick with the current dose and use the ReliOn to see how the numbers fall.

 

He's ok now. He was about 2 pounds underweight when he was diagnosed, but also had the KDA, which I think goes hand in hand somewhat. Now he's his ideal weight (they want him between 11-12 pounds), so I'm monitoring his food. He was getting like 4-5 cans of food a day when he first got diagnosed, just to get weight back on him. He's on 2 cans a day now, so basically I'm starving him and he yells at me every chance he gets.

 

When was the last ketone test? Since he's been a little higher . Also, with the numbers he may feel a little hungrier than he has been lately.

 

Ugh...I don't ketone test. At least not yet. I can't imagine that he would even allow me to sneak up on his pee. How long can the pee be in the box for me to test it for ketones?

 

Before I tried the spoon trick, I dipped the stick in a fresh puddle before litter absorbed it all. So I did have to "shoo" Maury out of his box when he went to cover it. I always reassured him I would cover it for him . He has enclosed boxes so I have to "open the door" and just sneak the spoon under him.

 

The shallow long handled spoon under the bum trick works really well. Try it! Just make sure you label it as Frank's spoon from now on.

 

I have a clean washed out Fancy Feast can that I keep near the litter box, and I just hold on one side and stick it under his butt, collect a little bit of pee, then let him go back to his business. I'm lucky that he always pees with his butt facing out.

 

Tonight should be a good cycle! I think that I'm so close to a good dose for him, but don't want to increase on a bounce. Maybe Sunday morning I'll up it to 4.

 

While I'm hanging out here tonight, can anyone shed some light on more regulated BG and behavior/personality? I don't know any people with diabetes, so can't ask them. I've noticed Frank becoming increasingly loveable as his BG gets more under control. He goes to bed with me, sleeps on the back of the couch by me, and jumps in my lap several times nightly for 5-10 minutes of petting and purring before he gets irritated, bites me, and runs away. (It used to only take 2 minutes to get him irritated.) So I'm thinking he must be feeling better now to be a bit friendlier, right?

 

It's still new territory for me but Maury is doing more of his old habits; more lovable, hanging out with me by computer more (used to do it almost all the time), talking, playing, sleeping in bed with me more, better appetite, and little feistier with lower BG's for testing

 

There are definitely things he's doing now that I didn't even notice had stopped. Like jumping on top of the fridge and crying until someone walks into the kitchen, then swatting their head/hair/face. But he's also more friendly than he's ever been in his entire life.

 

I do think it's partly that they feel better and partly that they KNOW you are making them feel better. People on here have reported having a much closer bond with their sugar cats than they had before the diagnosis.

 

I would agree with all of that. Going through this process has 'tamed' Sam like nothing else. He's still mostly a wild kitty, but more and more he's turning into a really sweet wild kitty!

 

I love your new picture!

 

Teasel has always been an attention hound so all the extra FD TLC is right up his alley. I think he enjoys the testing and injecting rituals because they involve a lot of treats and one on one time.

 

He even purrs at testing time. Maybe because sometimes he gets a snack (though not always)...Frank does love food.
And I was writing this he was on the fridge, crying. He always tricks the dog with this. You know how Lucy always tells Charlie Brown that she'll let him kick the football and then doesn't? That's the relationship with Frank and Belle. Anyhow, I had to shoo him off the fridge when the magnets all started raining down on the poor dog.

 

So close to that green! Did the play session help drop him? He'll probably go back up because he scarfed all of his over night food. At least on the canned food he doesn't scarf and puke like he did on the dry food.

 

Sleepy babies.

 

It's still possible he could make it to green by the +4! I love all the pictures around tonight! It's so fun to see everyone's babies!

 

I truly believe that the less I fuss over Chloe and don't stress with the constant glucose monitoring, she is getting her usual personality back. She still doesn't like the injections, but she is much happier not having her ears pricked.

 

Another one!!!! Fingers crossed this doesn't start 2 or 3 days worth of bouncing!

 

It's 130A and Frank is LOUDLY singing the song of his people. Something else he hasnt done in forever. Cute, but it's bedtime. And he's yowling.

 

He was celebrating his nice green!

 

Woohoo on the green! That's great!!!

 

Excellent!

 

Tonight's shot was late, but I was really happy with that preshot number considering the insulin was probably out of his system. I was going to start an 11/13 hour cycle to get those PMPS down, but I think instead I'm going to do a full curve tomorrow. (I need one for the vet anyhow, even though we aren't going to talk about how I've increased his dose without her advice. Oops! Lol.) I'll grab a few tests tonight too so I can see where we are.

 

I think I'm getting a few small bounces on the PS numbers, but today's cycle looks pretty good!

 

Another !

 

!!!

 

Woot woot! I think we're going to like this 4U!

 

Yayyyyyyyy!!!!!!!

 

Well, back to blue. Hoping Frank doesn't get too high!

 

A no shot PMPS...and the lowest PS we've ever had. One of the lowest BG we've ever had!

 

Hmm. Curious . Won't say anything just yet, nothing bad! Just got the wheels in my head turning

 

So I stalled for an hour with tests 20 min apart and got up to 206. I didn't want to go without a shot, cause I knew he'd skyrocket. Totally meant to give 2U and without thinking drew and shot 3. Yikes. Had to run out for about an hour but knew he'd be OK while I was gone. He got into a bag of spiral ham that I accidentally left on the counter while I was out (with a brown sugar glaze!) And still only tested at 84 at +4. So I panicked a bit, knowing he could go lower still in the next 2 hours and added about a tsp of honey to his nighttime food. Will get a +5 before calling it a night to see if I need to do any steering yet.

 

Wow! What an exciting night! I bet Frank really enjoyed the ham

Looks like he had a good night overall, even with that brown sugar! That's great!!

 

He was steering himself with food!

 

And this morning, a nice bounce....or a result of too much sugar.

 

Or from those greens.

 

I wonder if 4u might be a little bit too much for him? There isn't any daytime data from the 3.75u dose, but he did get into greens with it during the PM cycle. You might consider giving him a few more cycles at the 3.75 and see what happens.

 

That was part of my pondering in my last comment But I had not figured out which one to suggest yet. Still analyzing

 

Hard to know. I'm not very good at sliding scale dosing because I couldn't do it with Teasel. He's too volatile.

 

He was so high on his PS before, and now I'm nervous on his mid-cycles. I just want to start in the 200s, drop to the 90s, and end in the 200s. Is that so much to ask for?

 

Honestly, I've thought about starting back at 3 or 3.5 and giving it a full 5 days before an increase. I woder if those higher numbers were just him bouncing all over. Idk.

 

Sigh. This is so hard! Trying to make the right decisions, the right dosing, the right times. The right cat litter. I went to 3.5 again just to see, but after 2 cycles of high numbers, I bumped to 3.75 tonight. (I've attached a picture of where I filled, which might be slightly more than when I was doing 3.75 before. We had a quick drop, and I'll be testing in 10 minutes to see where we are. I just want to find the magical dose. So, all that said....advice on what dose to try over the next few days? Right where I'm at? Just a teeny tiny bit less? This is what I shot tonight. (Sorry, I didn't fill it with colored water. I will on a used one tomorrow, but currently all my used ones are locked in the sharps container.)

 

Oh...aannddd....green party!! I just don't want a crazy low green party, lol.

 

Just NEEEVVVVEEEERRRR satisifed, huh Sarah? That green from last night is nice! I'd stick with it for a few cycles and see what you get.

 

Nope, never. Haha. I love those greens, but sometimes he drops to green so fast I'm afraid he'll go hypo. But I haute the morning red and blacks. I liked when we were pink on the PS. It's an OCD thing, I think. I hate things that I can't control.

 

I used to be a control freak and still am in some areas but FD has erased a lot of it.

 

I can reasonably say that I KNOW I can't control this, it's a static diseases, etc, etc....then like 2 minutes later I'm stressing out that I can't control it.
What's better....when he was pink and yellows all day or now, when he's red/black and then drops so fast to green and back up to black? I stress that I'm not making the right decisions overall and that something I do will make it worse. The struggle is real!

 

Bouncing is infuriating as I well know. So far, 3.75 u - 4 u seems to be his "sweet spot" - doesn't mean he won't bounce but that range gives you good numbers when he stops for a bit. You could try leaving the dose at 3.75 u both AM and PM for a couple of days to see if the stability settles him a little.

 

I think a lot of us feel that way! We just WANT to control it, but we can't.

As for which is better, I would say neither really...he might have been more stable in pinks and yellows, but getting in those greens helps his pancreas have healing time even if he does bounce. I think it's the nature of the disease though...you see some higher numbers, and then you break through and have that bouncing...and hopefully over a short time he settles back in to lower numbers. I like Kris's suggestion of holding the dose steady to see if that helps.

 

I'm noticing that the doses look like they have been adjusted around a lot. I've been reading some of the older threads on here, that advocate for holding doses for longer periods of time to give the cat time to settle out all the bounces. Only using sliding scale dosing if you have ample data that it's necessary. If the cat is under 200 at PS, then a dose adjustment may be necessary, but above that, holding the same dose and only changing the dose after a minimum of six consistent cycles, and only changing if the nadir is too low or too high. Holding longer than that if you're getting 50-120 at nadir, or big drops from PS to nadir.

I agree with Kris that 3.75 might be a good dose to hold for awhile.

 

I'm just going to hop on the bandwagon with everyone else in holding that 3.75U . Side observation, are you using 11/13 schedule now or are the +#'s just accidentally moved to the left one column?

 

I'm doing 11/13 because his PMPS are always higher, and I an hoping to even those out some (although in recent days we've had high AMPS, too...but I'm blaming those on bouncing). I'm going to hold everything as it is for a full week, then see where I need to go I think.

 

Ok was just checking

 

I know I said I was going to hold Franks dose and times...then last night was late (life got in the way). Now this morning I had to give an adjusted dose; no way could I shoot 3.75 on that PS without being home to monitor. So those plans of holding at 3.75 and 11/13 went right out the window. Now I'm second guessing myself again. I need a drink.

 

You have to roll with the punches in this game ...

 

You hold the syringe, and always need to make the decisions that you think are best. That being said, you shot a 3.75 on 4/19 and 4/21 with similar pre-shots to today (262 and 289). Another factor to consider was that he had only had 11 hours to rise at that point. If you'd gone to +12, his number would likely have been higher -- and prozinc doesn't kick in that fast. So always better safe than sorry, but for what it's worth, I think the 3.75, or at least 3.5, would have most likely been okay.

 

A drink would help with that. Lol. It's 5 o'clock somewhere....