Meatball 2/18

Hello!

This is my first post on the PZI board, but I have posted a couple of times on the Health board. Meatball is only a year and a half old and was diagnosed Dec 23, 2009. After a short period of being HUGELY overdosed, he is currently on 1.5u 2x/day. He has been on this dose for 7 days... time for an increase? His numbers are much more stable now, but still high.

Thanks!
Molly

 

Welcome,
you made it -great. Looks like you have held the last 2 dose increases for 1 week each, and are keeping an eye on ketones. I've only been on the board since Jan 1 and my guy is unusual in that he is a high dose kitty with acromegaly, so i'm hesitant to advise, but I'm sure others will be along soon.

Is it possible for you to get data between preshots? It would be useful to know what is going on throughout the cycle.

And it would be great if you could fill out a profile, and post it to your signature. It helps folks who haven't been following your history answer future questions. :smile:

 

Wow, OK my input is that it's time to increase. I'd increase by .5u at this point. This is just my opinion and maybe other will have input. Nearly 700 to the 400's is improvement. You guys are transitioned to the low-carb wet ONLY right?

Are you guys using he U-100 syringes yet? If not this is something you should defiantly consider. It really helps.

Good to see that you got your profile together but unfortunately I get the error, "We're sorry, but uaser@gmail.com does not have access to this document." this has been a problem for another user recently I'm not sure if this is a problem because you are currently working on the doc or not? Anyway, just make sure it is readable to all.

As Nancy points out grabbing those in-between numbers is important.

Nancy good to have your eye on the "meatball" as it were. :smile:

 

I dont know if this will help but heres the link I used to set up my profile:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=486 There is a form you can fill out which is pretty easy (look for something like coolification link).

Yea, Gator, I'm branching out, and gonna bug you guys awhile :lol:

 

Nancy,

Bug on yo. You are always welcome here.

We need more eyeballs for the Meatballs.

 

Thanks, G! You're a riot :lol: :lol: :lol:

I get the same error message, I think you have to check "publish it as a website" or something, I remember some step where I had to check something to make it viewable to all. read through that link I sent and it should tell you if you missed a step. Hang in there!

 

I would definitely raise the dose more aggressively with trace ketones in the picture. The slowest I would consider going as long as ketones are around is an increase of 0.5u every 2 days (4 cycles per dose), and frankly I would probably raise it faster if I were doing it myself, though I'm not sure what guidelines to give you on that front.

I have no ketone experience, but I'd hate to see things turn into a crisis. If they are at a level where you should be headed to the vet (I don't know at what point that is recommended? maybe post on Health if you don't already know?), please do so. Sometimes in giving advice I forget that at times the best approach is not to finess the dose with trial & error & testing like we do here, and just get to a vet. Just mentioning that to be on the safe side since I just don't know all that much about ketones. I know it is important that they are eating well and getting fluids, which I think you noted in your spreadsheet, so that's good.

I'm surprised actually that you got a few good #s here and there on doses that look alarmingly high to me. To me that suggests that either Meatball is on a higher carb food/dry food (?), or there may be something else going on where he might actually need a higher dose. Sorry I don't recall any background if you have posted on Health, so I don't want to comment too far, but I'm thinking it's at least possible that he does need quite a bit more insulin. I don't know much about kitties on higher doses though, so perhaps occasional good #s like that are typical? I just don't know, sorry.

As for testing, as others have said if you can get some mid-cycle checks in (in the +5.5 - +7.5 -ish range ideally, to check for a nadir), that will help you raise the dose more confidently. If he is going from 400 down to 100 and back to 400, it's a very different picture than 400 to 350 and back up to 400. With my cat on PZI I found that I generally trusted the results on cycle 3 of a new dose. With many cats, I have been told you can tell by the 2nd cycle, but others can take a little longer til it's clear. Until you see nadirs even remotely in good #s (like under 200), I wouldn't worry too much at this point about letting a dose settle. You've waited long enough to be sure that any rebound from the previous high doses has had time to clear, so IMO you are now free to pick up the pace, and send those ketones packing!

Hopefully additional eyes will be along soon. If you want to post daily, that is ideal to be sure that all of us are keeping up with the latest #s and can give you the best advice. I would also consider adding "ketones" in your post header as long as you are seeing them, so we don't lose sight of that angle (and hopefully that will draw in some with more ketone knowledge/experience as well).

Welcome, and great job getting the data you have thus far!

 

Hi Molly--welcome to the PZI group. I won't have time to go read your old posts until later tonight, but wanted to add my voice to those suggesting that you raise the dose and get some mid-cycle tests. In general PZI can be raised at every shot, but that isn't a great idea. A more reasonable time to adjust the dose is at 3 days (every 7th shot). But since you're getting trace ketones, you may need to be more aggressive. That's why you need to get those mid-cycle tests. If the dose is dropping him mid-cycle, you wait a bit long on the increase. If he continues to stay flat, you increase more frequently. So please get several shots at different times during each 12 hour cycle.

I'd raise the dose to 2.0 this morning or this evening. I'd also add water to his food. Water helps keep ketones at bay. You could also consider asking the vet to give him fluids as further protection against the ketones.

 

Just to mention to those just joining, that I think (could be alzheimers @-) ) Molly started PZIR in Jan and got to 10u in about 2 1/2-3 weeks, then posted to FDMB looking for help.

After freaking a lot of people out on health, :shock: she was advised to drop the dose and start over much more carefully. Some of the more experienced high dose moms took a look and advised a start over (and improve food :?: ) as well.

I agree that she really needs to keep an eye on those ketones, and increase water, and jump to 2u, but assuming the ketones stay OK lets try to progress slowly this time.

FWIW- Cody is an acrocat, so ??? who knows what his tumor is doing any given day, but I am just now seeing a response to a PZIR dose increase almost a week after I upped it. PZIR is new so we're all trying to advise based on the next closest thing, PZI. Hang in there, just watch the ketones!

Molly, I cant read your profile it's still blocked

 

Hi Molly,
I'm glad you found us and I hope we'll continue to see you and Meatball here. You've already gotten a lot of good advice so I won't add anything. I just wanted to say welcome and hi.