Getting a baseline for Wilbur

Discussion in 'Feline Health - (The Main Forum)' started by johnt, Feb 12, 2018.

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  1. johnt

    johnt Member

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    This is a continuation of this thread if anyone wants context.

    Several people have been helping me work with Wilbur to get a good baseline for numbers and we just started altering his dose levels to bring him in line.

    This morning he tested AMPS at 274 which i know is a little high, but it's actually pretty stable and much lower than it was a week ago.

    If anyone has input on where I should go let me know. @Kris & Teasel and @Nan & Amber have been 'holding my hand' since after 6 years wilbur just now started letting me test. Others have stopped in too. I can't begin to say how thankful I am

    Kris I will get a +2 or +3 today and report back. I also raised his dose 0.25u today as suggested

    Also, I've reduced the temptations about 90% now. i'll be removing them completely in the next two days.

    Boy since I started feeding him small amounts of tuna his coat sure did come in nicely :)

    thank you!
     
  2. johnt

    johnt Member

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    Just did the +2 and it's 245

    Let me know when i should get another.
     
  3. Nan & Amber

    Nan & Amber Well-Known Member

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    Good morning, John! I'll defer to Kris (she's more attuned to Vetsulin cycles and the nuances of dose change responses than I am) on the next time to test, but I'm thinking maybe +4?

    Glad to hear that the tuna has its benefits (besides of course just being one of the few things that Wilbur will eat at the moment :rolleyes:)
     
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  4. johnt

    johnt Member

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    OK i'll do that, however I need to be cautious with him. he's still a bit gun shy and ifd I keep testing him frequently he'll start hiding again. But i'll get him at +4 which is about an hour and a half from now.

    While I'm thinking. I need to buy lancets. They're numbered like wire right? the smaller the number the bigger the needle? I'm using 30 gauge now. but I was thinking of getting smaller. i wonder how hard it will be to get blood from smaller ones.

    oh finally, i'm going to carve a handle for these stupid lancets, they're so tiny i kee dropping them. I carve small wood plaques so i think I'll make one. unless there's something else out there already? Do you know?
     
  5. Nan & Amber

    Nan & Amber Well-Known Member

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    This is why I was a little hesitant. I look at that +2 and think, we-eell, it's lower, but not too much lower, this might be a quiet day today and require less testing. But I don't have as much experience with Vetsulin, so I always try to err on the side of caution!

    That's correct on the lancets. It gets easier to use the smaller ones after a week or two-- the ears grow more capillaries-- and it's definitely easier on them. The tiny ones can be tough to use at first, though.

    They have little devices (come with most meters) that humans use to do the poke-- some people use them (without the cap) to hold the lancet. I'm sorry I'm not describing this very well, but if you look on the drugstore shelf with the other diabetic supplies, you'll likely see them.
     
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  6. johnt

    johnt Member

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    yeah i didn't think about that. I could just keep the cap off. good idea!

    He's hiding from me. if I can't find him in the next 30 minutes I'm going to have to bag it and wait till i see him. i don't want to chase him
     
  7. Nan & Amber

    Nan & Amber Well-Known Member

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    Aha, I was just writing a message clarifying that what I was trying to say is that I think that it might be possible to be a little less frequent with the testing today (I just default with conservative suggestions if I'm at all unsure).

    If he's hiding, though, that definitely sounds like he needs a break!
     
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  8. johnt

    johnt Member

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    he'll come back out.
     
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  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm back home now. Yes, let him have a break from testing. He didn't have a big drop at +2 so you can wait. Use your judgment about his mood re testing. You don't want to break the hard won gains.

    Re lancets: You can try thinner gauge if you like. I use 28 gauge with Teasel and have all along but if you think the 30s hurt Wilbur's ears you could try 31 gauge or a little thinner. I don't use the trigger mechanism but I put the lancet in its holder (without the cap of course) to give me something bigger to hold. It's the holder that came with the meter kit. You can try that.

    Re his impatience for PMPS testing: you could give him a little bit of tuna right before you do the test. Test while he's eating it if that works. It's low carb and if you feed it right with the test it won't have time to affect his BG.

    Would you say that the reds on your SS can be traced to some high carb treats, stolen or otherwise? I ask because if that's the case you can really see the strong effect they have on BG. I'm glad you're continuing to wean him off those. :)
     
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  10. johnt

    johnt Member

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    I could never do it while he's eating. his little ears move around too much. he fights his food :)

    I do give him a shot while he's eating though because his giant belly doesn't move.

    i might be able to get him here shortly.
     
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  11. Kris & Teasel

    Kris & Teasel Well-Known Member

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    No rush. Maybe a +6 or +7 if you want to try again later.
     
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  12. johnt

    johnt Member

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    actuallly I just found him and got it really quick. it's 133
     
  13. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Very nice number! :smuggrin:
     
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  14. johnt

    johnt Member

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    Yeah it looks like that .25 is helping
     
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  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You're learning the finer points of insulin dosing now. ;)
     
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  16. johnt

    johnt Member

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    it's interesting. that's why i thought "Well he was on 9 and 10u twice a day. how could .25 matter?

    I still can't believe he was getting that much, and honestly i'm not sure how this didn't kill him. it makes me upset to think about it. Thank God it's over now and in control
     
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    What's that saying? "When you know better, you do better". :smuggrin:
     
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  18. johnt

    johnt Member

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    No kidding.

    He was sketchy all day, I'm going to give him the rest of the day off other than his typical PMPS.

    tomorrow I'll stick to the 4.75 I assume? Since I got a +2 today should I shoot for a +4 tomorrow?
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, just stick to PMPS for today. You'll keep the 4.75 u for a few days to see what it does unless he dives low into lime green. You can try for +4 tomorrow.
     
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  20. johnt

    johnt Member

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    Sure thing. We're getting a better routine in and I'm feeling better. I am still hoping to get him off the temptations by Friday.

    I got those samples today. Wilbur didn't care about the salmon or chicken kibble, neither did Tinker. but i'll spend some time with them.

    I also received two cans of the salmon and two of the chicken wet food. if I can move wilbur to those to replace the temptaions that would mean he'd be off hard food completely. Other than when he skirts in to steal the hills.

    B ut Pickle, the 3rd kitty, LOVED the salmon. I'm hoping to get tinker on it too but time will tell.

    Feeling better all around though, sure am grateful for your help Kris
     
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  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Glad to help. :) It's so much better to be proactive than reactive, isn't it?
     
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  22. johnt

    johnt Member

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    listen, for 6 years I've been stressed. I tried several times visiting here and getting suggestinos but I just couldn't get him to let me test.

    This is the first time sinxce he's been diagnosed that I feel like I can get a good handle on him.

    About dosing. you mentioned go up to 4.75. but my problem is seeing those marks on the syringe. it's not a matter of practicing. it's a matter of I can't physically see the mark. My syringes only have marks at at the 1u point. Doing a .5 is easy, but breaking that down gets tough.

    here's my point. This is the syringe i'm using. See how tiny this is? it's very difficult for me to determine where the 1/4 marks are between the 1u markers.

    do you use a different kind of syringe? maybe I should switch. the yellow arrow point to the very bottom of the syringe marker. to me this dose is just slightly more than 4.5 and not enough to be 4.75 ( i didn't try to be on point, just loaded some up to take a pic)


    dose.png
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, whole unit syringes are hard to use for fractional doses. If you want to keep using these you can eyeball 4.5 u fairly easily. What I would do to get something between that and 5 u is fill the syringe with insulin to the bottom of the 5 u Mark (ie. the side closest to the 10 u line) and then carefully move the top flat surface of the plunger to the top of the 5 u line using a twisting motion on the plunger for better control. Once you see clearly it’s in that position, twist the plunger slowly to release a drop or two until the plunger top is slightly closer to your estimate of where 4.5 u would be.

    You can buy U40 syringes with half unit marks from ww.adwdiabetes.com I think. Another thing you can do with a U40 insulin is to dose with U100 syringes that have half unit marks and a conversion chart. That allows more dose fractions like 0.2, 0.4, 0.6 and 0.8 u. Those half unit marks are important.

    I use Levemir insulin for my cat. It’s a U100 insulin so I use U100 syringes with half unit marks. I routinely have to eyeball 0.25 or 0.75 u fractions but I also use finer distinctions like “fat” and “skinny” doses - ie., a drop more or a drop less.
     
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  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    BTW - that’s a really good curve today: similar range AM/PMPS and near middle of cycle BG about 50% of PS values. Ideally for an insulin like Vetsulin that has a smile-shaped curve, you want PSs in the low 200s and a nadir in the high double digits or low 100s. Today’s numbers are darn close.
     
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  25. Chris & China

    Chris & China Well-Known Member

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    These CarePoint U40 come with half unit markings

    Also these BD U40 come with half unit markings

    They are both available at ADW
     
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  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    What do you think changed so that Wilbur let you test him?
     
  27. johnt

    johnt Member

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    It's all me. It's because i was nervous, uptight and unsure of myself before. This time i just went in with confidence and made him comfortable.

    he's getting better. i just got him while he was trying to eat. It was time for his shot and i'd been holding him off from food. i came in and he was sneaking kibbl;e so i just grabbed the tester, sat down with him and pet him a bit. He realized I was going to do it and squirmed just a little, but since I can get it without it hurting him now it happens fast, and then i pet him a lot. So he likes that part.

    Was a little high today though. 347.

    I seriously think he's sneaking kibble.
     
  28. johnt

    johnt Member

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    Here's the issue I have and it doesn't make sense.

    the unit in the picture above is a u-40 1/2 cc 29g

    I have others that are more expensive and have multiple markers. but they're smaller (the markers), they are 40 units.m 1mL

    They're also 28 gauge which i thought meant they'd be bigger than the 29. am I wrong? because with the one pictured below (it's called monoject) it's difficult to get the insulin to go in. Whereas the others it goes right up.

    Am i backwards on the gauge/size?

    mono.png

    one last thing. I have a repairman coming at 10:00am (10:30 would be +2) so I might be late on that. if I am should I just do a +4?
     
  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Unfortunately it's the human who has to control the access to diabetic kitty contraband. o_O

    Re syringes: you don't need larger capacity than 0.3 mL (cc). Any more than that and the marks can be too close together. Those syringes with the red caps and no half unit marks are what vets often sell to go with a U40 insulin like Vetsulin or ProZinc. I've had them but stopped using them when my cat was on ProZinc.

    For needles, get what you and Wilbur are comfortable with. Many people use 31 or smaller gauge. I use 29 gauge and always have. Some people like shorter 1/4" needles but I've always used 1/2" with no problem. Either of the ones Chris recommended above in her post (#25) would be absolutely fine.

    Here's a conversion chart you can use to dose U40 insulin with U100 syringes:
    http://www.felinediabetes.com/insulin-conversions.htm
    This is what many people use and is what I did when Teasel was on ProZinc. It works really well to allow a multitude of dose fractions. U100 syringes are readily available at a human pharmacy but you need to ask for those with half unit marks. They can also be ordered from the link Chris gave you above.

    Try for a +4 or +5 if you're busy with the repair man.
     
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  30. johnt

    johnt Member

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    I will. the jerk never showed up yesterday so i was tied up waiting. He'll be late today.

    Off topic but it really bugs me. I'm leasing this house for my mother for a year before we decide to buy or not. I bought a new kitchen faucet, called and told him and said I wouldn't take it off the lease, I'll just pay. Before I hung up I told him id install it like I do everything else here.

    he insisted I let his son do it since he's 'out of work' and is a retired plumber and needs the $. So I paid $250 for a faucet that I have to have some unemployed half wit install. Nice! that's why it wasn't done yesterday, he never showed up. Sposed to be here at 10 today, I know he wont.

    about a 10 minute job if I do it. would have been done 2 days ago.

    anyway, ok sorry. just makes me mad.

    If he's not hear yet I'll get a +2. I know it's my fault on the kibble, but I'm changing a lot on him anyway, and feeding him a lot less now that I'm testing and can manage a weight loss program while not worrying about glucose so much. I don't mind slipping on one thing, but this is twice and it's interrupting the testing, so no more.
     
  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Do the best you can. You've introduced a lot of changes into Wilbur's life. If you can ever get him on low carb wet food only I'm pretty sure the weight loss will happen on its own. Try to get some freeze dried fish treats next time you're in a pet store. You can also use little bits of Bumble Bee tuna as a treat if that's his favourite.
     
  32. johnt

    johnt Member

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    i got him but it was 366 which is pretty awful

    I've got to find a way to keep the food from him. Once all the people are out of the house I'm going to pull the 3 bowls and just leave water. when i give him a shot i'll put it back
     
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Well, at least you’re getting an idea about his level of carb sensitivity. ;)
     
  34. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If the only food that's left out is either low carb kibble or low carb wet food you don't have to take it away except for those 2 hours before his PS test is due. If he's a grazer by nature try that. It'll be interesting to see if you can sway his taste in food. Kibble is very addictive to some cats and Temptations treats even more so. I keep a bag of them to use if Teasel's BG is too low and he goes absolutely bonkers with excitement when I open the bag. They're dangerous! ;)
     
  35. johnt

    johnt Member

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    @Kris & Teasel, lovely. I just noticed something. I only have 26 strips left. I had already ordered 100 more, but it will be 7 days till they're delivered. That means 3 per day. is that going to be enough?
     
  36. johnt

    johnt Member

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    All i have at the moment is the hills, which definitely isn't low carb. but i'll find something else. just take a little time

    that really bugs me too. I pay a lot for that food at Chewy ($66 for a 20lb bag is expensive to me), and I did so thinking i was getting premium food. I might as well have gotten meow mix from walmart at $20 for the same sized bag.
     
    Last edited: Feb 13, 2018
  37. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Are they available in a pharmacy where your type of human meter is sold? Could you buy some there to fill the gap? You might be able to squeak by for a week with those 26 strips but what if he decides to dive and a little more monitoring is in order?

    Re food: you probably are getting premium food but unfortunately it's too high in carbs for a diabetic.
     
  38. johnt

    johnt Member

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    Actually I just checked and it looks like Walmart carries these.

    I just didn't think, I ordered a new 100 strips that arrive Feb 1. So i just didn't expect to run out so fast. Going to see if I can find them at Walmart, and if so just buy 400 on Amazon. they're really cheap there. about $56 for 400 and that should last a long time.

    Jeeze I feel dumb. i guess it just dind''t dawn on me..
     
  39. Nan & Amber

    Nan & Amber Well-Known Member

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    Oh, you're ahead of the game! Realizing you are running low when you still have 26 left is pretty good for the first time running low! For a lot of folks, the realization hits when they have 3 strips left, it's midnight, and kitty is going low (they always know, somehow! :rolleyes:)

    Good plan to stock up. :)
     
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  40. johnt

    johnt Member

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    yeah I just had no idea i'd get to the point I'd go through a hundred so bloody fast. The next one's will lat a long time.

    Shame the Verio Flex tabs aren't cheaper. I have two of those that are USB and paired to my cell phone. Could use one but the refills are $39.87 for the verio Flex, or $17.00 for the TrueTrack tester. At over 50% cheaper it's a no brainer.

    But i'm paranoid like that. i counted what i had left and then looked at the delivery date for the new ones and it dawned on me I don't have enough.

    Just got back from Wally World. Saw on the Walmart.com they show $16 for 100 test strips. But when i got there they only carried the more expensive strips. That were easily double the price. But i wasn't going to start over from scratch
     
  41. johnt

    johnt Member

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    @Kris & Teasel FYI i just got him PMPS and he's at 265. THought I'd post before dosing, I'm going to stay at 4.75 unless i hear otherwise. I'll give it a few minutes before going ahead

    Also, I ment to say I ordered the others and they got here Feb 1. But because of all the testing I noticed I was getting low, so I counted what I had left to figure out how long they'd last. It lokos like i can use 4 per day right now. I should only need 3 though. I did already place that order for 100 that will get here the 21st. But i also just ordered 400 more so id be set for awhile.
     
    Last edited: Feb 13, 2018
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  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Early night for me so I didn't see your tag. The few hours time difference between here and where you are can mess things up. I'm glad you gave the 4.75 u. Aside from the (possibly) kibble-induced highs you're seeing a pretty good response at this dose. Stick with it for now. If the pinks and reds are from contraband and I look past them, he's got good duration from the Vetsulin and isn't a crazy bouncer. Won't know for sure until you're further into your new feeding regimen but it looks promising.
     
  43. johnt

    johnt Member

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    Sounds good. he's doing well. although this morning the poor little guy kept trying to throw up but couldn't get it. Man, all 3 of my cats throw up, and with fosters I've seen hundreds over the years. but when he does it it's violent and i can tell it hurts because for several minutes afterwards he winces when he swallows. And yes he ate well after he got through the heaves, i'll keep an eye on him

    Anyway, 254 AMPS so we're still in line. much easier to keep him clean for 2hrs in the morning. Starting last night though I removed all access for all cats. not like they're going to die in 2 hours and since I don't hand feed the other two at all they probably wouldn't beg,
     
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  44. johnt

    johnt Member

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    @Nan & Amber Something I noticed looking at Amber's SS. When you changed to young again it instantly dropped into the blues during your testing. Can I ask if the food you were feeding prior was also low carb?

    Also, it looks like it really worked when you started using an auto feeder. I don't think i'd have a problem with Wilbur on that because I'm always around him but i might consider this anyway for all 3 since it would force 'no cheats'. I tried to figure out what "OTJ" meant but couldn't. Can you tell me what that means?

    Finally, the claim I keep seeing from the YA site is that yes it's expensive but they will eat a lot less of it so it's not really that expensive. I assume that's hyperbole but thought I'd see what you think after using it for a bit.

    Now i know Wilbur isn't going to drop like that, he's way too high and it's been too long, but if the Young Again helps that much
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    OTJ = “off the juice”, ie., a diet controlled diabetic.
     
  46. johnt

    johnt Member

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  47. Nan & Amber

    Nan & Amber Well-Known Member

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    Hi John!

    Yes, by that time she'd been on low-carb for a while. I'm not sure the addition of YA made a difference in anything other than her grumpiness (she was a hard-core kibble addict and was thrilled to get some crunchies back!), so it was likely just coincidence.

    I'd say that's definitely true. The problem I have now with the YA is that, at some point, Amber decided she wasn't all that happy with it after all and she just stopped eating it. So did my civvies, who had been dipping in once in a while (I kept a bowl out for free-feeding, and after a while I realized I hadn't had to re-fill in a while). Hopefully, if your kitties like it, you'll have better luck getting them to stay on it.
     
  48. johnt

    johnt Member

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    I was asleep at +3 but I got a +4 at 178. I'll get his PMPS and see if I can get the +3 tomorrow
     
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  49. johnt

    johnt Member

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    I have a general question. This morning wilbur tried to throw up but gave up after a few minutes when nothing would come up.

    it just happened again 6 hours later. is that OK? normally he gets a little yellow stuff out which i read was normal, but he can't seem to bring anything up. don't know if i should be concerned or just let it go
     
  50. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Is he prone to fur balls? Does he have less access to food than he's used to? Some cats build up stomach acid when the stomach is empty and they'll vomit watery or foamy liquid. Maybe try giving him a very small snack periodically - low carb of course. You said that he ate well after this morning's episode (and kept it down?).
     
  51. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I see the pink PS for last night and the yellow after it. If it’s not from high carb food it could be a little bounce or shorter insulin duration. At least he came down well, if not into blues. Keep the same dose for today while you keep working on the food routine.

    How is the vomiting situation? Aside from that is he feeling OK?
     
  52. johnt

    johnt Member

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    Couple things.

    Those spikes are almost surely when he's sneaking into the other room and stealing the kibble. I put it down when i gvie him his shot. The bowls are in his room and the third cat's. not sure how to stop it until I can get them all on other food.

    I am going to try it soon, but I'm on a fixed income, and he costs me a fortune as it is, it was $460 when i took him to the vet 2 weeks ago, his insulin cost will now drop $45 per month (if we stay here) and I tend to my mother who is going blind and not in good health.

    So it's difficult to find money to buy expensive food. i guarantee you he eats better than i do.

    The vomiting is different. it appears like he's choking, but I can tell he gets air in and is trying to bring something up but it never happens. he's having this happen a couple times a day now. I don't know what to do. My assumption is he's got a hairball. whatever it is it bugs him but then he just gets over it and goes back to normal.
     
  53. johnt

    johnt Member

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    Also it just dawned on me. His 'meower' has been broken for about a week. When he meows it sounds rough, or no sound comes out.

    I bet it's from all that hacking.

    Believe it or not, all those fosters, having these 3 cats, 2 of them for 10 years now. i've never had a cat with a hairball. any suggestions? I read about some remedies that 'coat' the hairball, but then I read people saying that's bad for cats. Getting them off grain food is better.

    It really stinks being so limited on options
     
  54. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Laxatone is one common hairball remedy but it might be too high carb. Some people use plain Vaseline if the cat will lick it up - main ingredient in many hairball remedies. Does it look like he's trying to vomit or is it more like coughing?

    It's unfortunate that he won't eat low carb grocery store food because they're a lot easier on your wallet. Did you get samples of the Young Again yet? Have you tried the canned Dr. Elsey's? I think you said he didn't care for the kibble.

    Re feeding segregation: you might consider training your three to eat in separate rooms at scheduled meal times so they can each eat their own type of food. Then, take away all food bowls after the meal time and leave out some low carb kibble for all three to graze on. Yes, it will likely be hard and there'll be much protesting but as long as no one goes on a serious hunger strike it should work out over time. I'm sure you've thought about this type of thing but maybe dismissed it because you know your cats' habits, etc. Maybe give it some more thought? Remember - you thought you'd never be able to test Wilbur's BG and look how far you've come with that. ;)
     
  55. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    It doesn't look quite the same as throwing up. He starts by sleeping then jolts up and coughs. then he sits in that position like hs' going to throw up, but instead keeps doing that coughing.

    It looks painful. When he's done is when he flinches every time he swallows. It also kind of sounds like he's wheezing when he's coughing.
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    There are a variety of possibilities, asthma being one. I think a vet check as soon as you can manage it financially would be a wise move. Teasel's brother went through a spell of what seems to be something similar a number of years ago. I was never sure what it was but it stopped when I switched cat litter from something dustier I was using to Dr. Elsey's (blue bag). Teasel and his sister had itchy paws from that dustier litter and that stopped with the Dr. Elsey's.
     
  57. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    I'll watch him. It's unusual for this to happen. I've only seen him do it two days. Yesterday and today. Thought he was throwing up. But i studied it a little more this time.

    If it doesn't improve I'll take him in. The sessions seem to take 3 minutes or less, and he doesn't wheeze inhaling, only exhaling but it could be when he's trying to get whatever it is up. I have asthma myself and when I wheeze it's both in and out most times.

    ALso, I just got his AMPS and fed him. he was 279 and I stayed at 4.75.

    I'm going to have to figure out another avenue for test strips. I got notification from Amazon today that said this:

    I can't wait much longer so i ordered strips for my verio onetouch flex tester. They're over twice the price, so i only ordered 100.

    even the verio strips won't be here until the 20th and that's with Prime. No clue why i can't seem to get anything here sooner. Sure am glad I started looking when i did!
     
  58. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I think the simplest thing would be to go buy a ReliOn meter at Walmart. The Micro and Confirm take only a tiny blood drop but the strips are around $30+ per 100. The ReliOn Prime has cheaper strips (around $18 per 100) but uses a slightly larger blood drop. I only know this from other posts here. I can't get these in Canadian Walmarts. If you have a Walmart nearby you won't have to get caught short of strips.

    That's a good AMPS. Keep this dose for now.
     
  59. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    I am.
    I got the test strips covered today. They will no longer be a cost issue. So i'm relieved. I'll be picking up a new tester today.

    His +3 was 140. how should I test him going forward? just the AMPS, PMPS and another one somewhere in between?
     
  60. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    That's a great number! The drop was a bit steep so try for a +5 or +6 if he'll tolerate it. Looks like he's more with the program based on the number of tests I see on your SS. :)
     
  61. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Any more vomiting today?
     
  62. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    He coughed once, but that was it. it doesn't seem to happen during the day much. mostly at night, or early morning.

    I got his PMPS on time i just didn't log in quickly this time (Olympics are live). he was a little higher at 363 and he really doesn't care for my 2 hour starve out.

    since his sugar was so high i am thinking he had to have gone in to the kibble
     
  63. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Not to backtrack an earlier post. is this what you're referring to?

    https://www.adwdiabetes.com/product...NUtFzXFqqFSI7BGy9Y0KqBcA_5YcEAKoaAkMvEALw_wcB

    i've been looking and haven't found a 5u syringe but that would be nice. Only problem is we may well be passed 5 when we're done getting him set so i don't think that's a good idea just yet
     
  64. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The syringes in that link are good for up to 12 unit doses. I doubt very much you'll ever get there - your data suggests that around 5 u plus or minus a little is a good dose range for him. They'd be very helpful for you right now in drawing up 0.25 u fractions when needed and they aren't expensive. I'd order some.
     
  65. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You have to make that impossible for him. Yes, I know - nag, nag, nag ... :stop:
     
  66. johnt

    johnt Member

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    Feb 14, 2016
    Oh my god. I just looked and got my days mixed up. I thought I took Wilbur's blood today and gave him a shot but there's no way that happened. I had a 6am meeting, 99am doctor appointment, then my mother's appointment at 11.

    I just looked at my chart and did his pmps and it's terrible. I looked at my replies and it appears I missed the entire day??????

    When should i test him again?
     
  67. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I'm seeing data for yesterday, Feb 15. I see a PMPS for today that's red and it's not evening yet! ;)

    I suggest a caffeine infusion and then take another look at your SS. :smuggrin:
     
  68. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I'll check in after you've sorted things out.
     
  69. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    oh man.... nevermind. I thought it was 8pm right now.

    I've had issues with stress and sleep so i sometimes i nap in the afternoon.

    I still don't understand how his sugar could get that high if I tested him last night
     
    Last edited: Feb 16, 2018
  70. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    I did. I logged the shot i just took as 8pm thinking it was at night.
     
  71. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    He's thrown reds before. It could be a bounce reaction to a low overnight that you didn't catch or he might have found some contraband. Don't worry - it's the overall trends that count and that's what I'm focusing on. BTW - you entered his AMPS in the AM dose column. Have you given his AM dose yet?
     
  72. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    i fixed it. I was panicked because I woke up right when it was time to dose him. since I was still really groggy I hadn't opened the blinds yet. I assumed it was pm.

    I looked at his chart and saw nothing for the AM then a 400+ reading. that's why I thought I had missed this morning.

    Just ignore me until i have coffee :). i'm sorry
     
  73. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    No apologies needed. I'm a coffee addict. ;)
     
  74. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Give some thought to ordering those syringes.
     
  75. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    I'm going to. I don't remember by reading but what I found strange was, the Monoject syringes I assumed were smaller diameter. because when I went to pull insulin it was always a chore, even if I injected air prior. But with the cheaper ones I posted the pic above, i never had to prime the vial at all, it pulled the insulin right in. I'm hoping to avoid the prior issue because it wa annoying :)

    Then i read the labels and they're the same

    But at $18 shipped it's worth a trial run.
     
    Kris & Teasel likes this.
  76. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Try for a +5 today.
     
  77. johnt

    johnt Member

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    Feb 14, 2016
    After looking at the SS that's what I figured would be best. Will do
     
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  78. johnt

    johnt Member

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    Feb 14, 2016
    he's just right at 143 +5 so i'm happy there. it's getting really hard to stop him from eating though.

    i've removed the temptations as much as possible and for the time being i'm alternating between the simple servings (wet) and the canned tuna. I hate to say it but some times I replace the temptations with tuna because I know (from that chart) how high his BG goes when he eats those. i try to keep him only eating them when i'm dosing, and I need to take them away completely. just a little at a time.
     
    Kris & Teasel likes this.
  79. johnt

    johnt Member

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    Feb 14, 2016
    @Kris & Teasel One other thing.

    Listen you have gone beyond the scope of helping someone a million times over here. I don't deserve the patience you've given me or the continued help.

    if you'd like to give me some guidelines to hit with Wilbur I can write it up and set a plan out. I think you can see from my testing I'm serious about this.

    You don't need to waste a bunch more time checking his chart every day.
     
  80. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I honestly don’t mind checking in. However, if you’d prefer that I leave you to it I can do that too. I think you know the basic guidelines around testing, dosing and feeding so you can run with that. Whatever works for you ... :)
     
  81. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    I'm happy to get any advice you have. I just don't want you to feel burdened to have to keep checking. I'm not about to just think i've got it.

    Don't you think he's still a little too high though? i assumed you'd want to go up another .25
     
  82. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, you can bump him up to 5 u tomorrow AM. I prefer AM dose changes because it's easier to monitor through the daytime. I’m glad you’ve seen concrete examples in his BG numbers of the big effect of those Temptations treats.
     
  83. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    I gave him 5 this morning. his AMPS was still higher than i'd hoped for at 334

    Since I've raised him another 1/4 what time should I check him again? +4 or +5? somewhere in that range?
     
  84. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    @Kris & Teasel something I meant to ask you. in reading your signature it shows you've changed Teasel's Insulin several times over the last year or two. Can you tell me why? is that something I should consider for Wilbur? would another type handle his curve better?
     
  85. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You could try a +2 to see if he's dropped a lot. That's a fairly good predictive test. If his BG is similar or only slightly lower then, try again at a time that will add good data to your SS.
     
  86. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    That's significant drop at +2. Test again at +3.
     
  87. johnt

    johnt Member

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    Feb 14, 2016
    ugh I just got back and sat down. i was out. he's bouncing around right now. soon as he settles down i'll get one.

    Won't be long

    See how glad I am you're still here? i didn't think that was a big drop when looking at his others.
     
  88. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Teasel is extremely bouncy and hard to regulate. He was started on Lantus but I was clueless and only doing curves for my vet - that revealed nothing about his responses. He was switched to ProZinc after his DKA 2 years ago and lived on his trampoline despite my attempts using FDMB help to get him evened out. I then went back to Lantus and succeeded in getting him in better numbers but keeping him there required a lot of testing and intervening with snacks. He didn't feel well on Lantus - lethargic and sometimes irritable. I can buy insulin OTC here in Canada so I took it upon myself to switch to Levemir. My vet wasn't involved at all. He's happier on Lev but still bouncy.

    Wilbur might do better on Lantus or Lev but they're expensive in the US. A lot of people there order from a reputable Canadian pharmacy in Vancouver, Marks Marine Pharmacy, for about half the cost in the US.
     
    Last edited: Feb 17, 2018
  89. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Wow. nice to know. I would need a prescription though to order from Canada correct?

    i thought about mail order before but figured shipping would be a fortune since they have to remain cooled
     
  90. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I think I've read here that once they have prescription on file you can keep ordering. They pay attention to weather, etc before shipping. @Chris & China is the Marks expert here.
     
  91. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Ahh ok. Well i found one linked here, but i sent an email to their contact email and it bounced back lol

    https://rxcanada4less.com/contact.html

    I'll find one. but holy moly lantus if expensive. I was using ProZinc for Wilbur but it was $124 per bottle so my new vet switched me to Vetsulin which is about half that
     
  92. johnt

    johnt Member

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    Feb 14, 2016
    +3 is 170. looking at the chart that seems pretty normal for him.
     
  93. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, Lantus is expensive but here's the thing: it's a U100 insulin, meaning it's 2.5 times more concentrated than Vetsulin. If you buy a 5 pack of Lantus cartridges at 3 mL each, that's 15 mL or 1500 units of Lantus. If you give 10 u per day, say, that's 150 days of insulin. Look at it that way.
     
  94. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yup! Looks good. You can either test around +7 or wait until PMPS. I get the impression that the testing thing is a lot more routine for you even if it isn't Wilbur's favourite thing.
     
  95. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Shipping from Marks is a flat $25 (usually arrives within a week) and they also offer a special cooler for another $10, but I've never had any problem with any of the insulin I've gotten from them (and I've gotten Lantus 4 times since I found them)

    Yes you'll need a script, but once they have it on file, you'll never need another one! They've refilled China's from her original script without having to get a new one every year like we have to do in the US.
     
    Kris & Teasel likes this.
  96. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Thanks, Chris. :)
     
  97. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    I'll take a look at this.

    The reason I put it on the shelf was. for one I'm using vetsulin which they don't carry. But if shipping was $25.00 that means to make it worth doing the cost of the vetsulin would have to be less than $20.00 or it wouldn't save much. I pay $57.00 after tax right now which is incredibly cheap. When I was using ProZinc and giving him 10u morning and night it would only last 3 weeks. But that was also $125 per bottle.

    I need to calculate the differences on using u-100 needles instead of u-40 and switching to something like Lantus. If that's cheaper and the $25 make it viable I'm all for it
     
  98. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    You also have to add in the unknown factor.....If Lantus is a better insulin for Wilber and would give him a better chance at remission (or at least a better quality of life)

    While Lantus is more expensive than Vetsulin, it's usually also a better insulin for cats. If you could get him down in dose by using a different insulin, that has to be considered too.

    When you compare ProZinc to Lantus, it's actually about the same price (at US prices)....Lantus is even cheaper if you get it from Marks!

    ProZinc is a U40, so a 10ml vial holds 400 units (for about $125)

    Lantus is a U100, so a 10ml vial holds 1000 units (for about $300 US....$100 from Canada)

    To get 1000 units of ProZinc, you'd pay $312.50....so it's pretty much the same as paying the US price for Lantus
     
  99. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Right. but see since I was giving him 20u per day before, and now i'm at 1/2 of that, it makes those much more viable options.

    I have to also weight my tight budget too so it's a fine line on what I can pay for.
     
  100. ELLIOTT & Fran Munschauer

    ELLIOTT & Fran Munschauer Member

    Joined:
    Jan 1, 2016
    Any newcomers to VETSULIN???? I switched Suzie from Lantus to VETSULIN 2 days ago because I am exhausted worrying about BG's ,staying up for 60 days wondering "How low can it go?"
    HAS ANYONE, WHILE TRANSITIONING TO VETSULIN 2u, EVER HAD WILD BG SWINGS DURING THE FIRST 2 DAYS?? Later on I can see it..but it doesn't make sense to me that on such a low dose during the first 2 days??? I wonder just how stable the amorphous/crystalline parts are..can't find much on research....BTW Yes, she's a dog..but don't think it has much bearing on these issues. Handling and srorage since received has been "by the book"..Any info would be appreciated.
    https://docs.google.com/spreadsheets/d/1O1YNDHz-t4REns_tbAN6D_M3AYT6_kgqbHE7JWo6kSM/edit#gid=0
     
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