? mr b's rollercoaster

LOL no kidding!? Whaddamigonnado with this goofball?! What the heck is going on?!

 

Enjoy it while it lasts, Jen. You've seen he's got it in him to respond even if it's in fits and starts ...

 

You now have absolute proof that Mr B is indeed a kitty. This means that one of their main jobs is to totally befuddle their beans.

 

LOL its official!

 

Yea for yellows! I'm so happy for you both - what a relief that he CAN respond to the insulin. Hopefully this is the start of better things

 

Damnit i think i screwed up again. I dosed early to get back to decent hours for 12/12 dosing and as a result i think i gave him too much overall and he's bounced up into the reds again. I get confused trying to figure it out in retrospect what i dosed in total because its hard to read the ss when going off the 12/12 format but i think i gave him 12 or 16 u basically wihtin 24 hrs. Too much and i feel like a jerk.

Gotta give him something this am though its another early dose. Its either that or he goes many more hours with nothing which i'm guessing would be worse. I have to go to work. I,ll give him a small dose of 2u i guess but i really dont feel confident no matter which way i go. Poo.

Not sure what to do here

 

Don't be too hard on yourself, Jen. You have a very tough situation to deal with. Here's a practical suggestion: how about inserting a new column on your SS at 4 hours and 8 hours for AM and PM cycles so you have a place to record "off schedule" doses? You could leave them blank when you're dosing 12/12.

 

i ended up skipping his am dose, rather than giving him what i was perceiving as more on top of already too much, and it would've been given at +9.

i'm just going to be late with his pm dose by a couple hours. it'll be interesting to see his ps #. i hope i didnt royally screw up (again) by skipping, but after looking at the history, my gut said to skip it.

i dont want to change the ss format because i'm aiming to get back on 12/12.

 

That sounds fine. It may take awhile to get things back on track, but I think you are headed in a good direction.

 

thanks. paws crossed!

 

That pink isn't so bad ...

 

yeah i was glad to see it.
got crappy news from the vet though about his bloodwork. thyroid levels up and kidney values starting to show. i posted on main forum.

 

Checked your SS, Jen. I'm glad his poop has improved even though you had to give him the DM. You've been keeping him at 4 u to get him stabilized which was a good move. What are your thoughts going forward?

 

Thanks. No idea. I'm out of ideas. Nobodys' advice works and no vet can help me.
Vet says fructosamine is normal so i guess mr b is ok. Yes i am being totally sarcastic.

+6 just now is total crap.

 

You were up at 4.8 u when those two blues appeared and then things got complicated. You have nothing to lose by going to 4.2 u, then 4.4 u, etc. keeping AM and PM doses the same to keep variables to a minimum. If you follow StepgG's thread for Chuck you'll see she's getting some traction with him now that she's at 5.4 u.

 

I've had blues at lower doses as well.
The blues we had on 4.8 were because i started dosing at +8, which was great for about five minutes, then everything went to **** again.
Last time we were at 4u we got some yellow preshots. Not this time.
Nothing works. And now his thyroid and kidney levels are up. He's dying and there's nothing i can do about it. I knew something else would come along before i could get his diabetes under control.
And the vet says dont treat the thyroid, and i disagree with that. Left a msg with our usual vet to see how she felt about it. Sought help on other sites and got hardly anywhere.
I'm fed up.

 

I would keep increasing. He seems to do okay with an increase at first, and then plateaus. If he were mine, I'd increase by 0.25 every 6 cycles until you see some better numbers.

I know this is hard, Jen. You are doing the best you can for him. And don't forget - he has no idea he is sick with diabetes. He is just hanging in there, having some good days and some not so good. I'd guess overall he figures life is okay - lots of attention, good food, good snacks, and a loving mom.

 

I agree with Sue, Jen. Please don't give up on Mr. B. To those of us on the outside looking in, you still have dosing options to explore. His thyroid and kidney issues are making it harder but not impossible. I recall reading a comment elsewhere about a cat not responding to insulin and the simple answer was that he/she hadn't yet received a high enough dose. Your maximum dose so far has been 5.8 u when you were trying TID dosing. You're still a long way from what high dose kitties receive.

 

4.2 u. !

 

I'm sorry Mr B's numbers are causing you stress again, Jen. The kidney and thyroid values can be transient - I had a CKD kitty and his numbers were highly variable. He was with me almost 2 years after his diagnosis and lived to be 18. I know Mr.B's BG levels are still high, but you got some lovely numbers a few days ago so he can react to insulin. The correct dose can be a moving target, and it's a very frustrating dance when we can't hear the music.

 

I like that mid-cycle yellow.

 

You're definitely making some progress, Jen! Hooray for yellow at mid-cycle!

 

OMG!!!! I love that blue, Jen. So glad for you!

 

Thank you!

 

Thanks! And still blue the little goof

 

Oh my! Look at those blues! Congrats!!!

Are you stalling for a shootable number?

 

Yes, that's what Jen did. Our conversation about it is on the other thread in the main health forum.

 

Awesome! I figured you or Sue would have offered your expert guidance - I didn't think to look at her other thread.

And great job persevering Jen! I'm glad your hard work for Mr. B is starting to bear fruit

 

right. either it was a little too little dose last night, or maybe too much (?) or he's bouncing because of so much blue yesterday.

its ok. just such a relieft seeing that blue. i hope its not a fluke.

 

Most likely the 3u was too small a dose but you need to play it safe until you get more data for these low-ish PS situations. The red this AM could be from too low a dose last night and/or bouncing from the blue. Hard to know for sure. Just keep doing what you've been doing and viewing results as just numbers, no more than that ...

 

thank you!!

 

Lovely string of yellows yesterday. Probably a bounce number this AM. Looking good.

 

Just now I was wondering if maybe i shouldve dosed lower last night, after that comparatively low pmps.

Or if maybe i should nto have increased thhis am after that nice run yesterday.

Hard to say maybe?

I keep thinking he'll act happier when he's got a decent run but he doesnt seem more comfortable at all. He was up and down all night, so once again i am exhausted from lack of sleep. Damn this disease!

 

Hard to know for sure. If he's pink the rest of today you could try going back to 4.4 u tomorrow to see what happens.

 

That yellow last night is interesting. There's something going on but I'm not sure what. Keep going, Jen.

 

Thanks for keeping an eye on us. He can be pretty restless at night, keeps waking me up. I was surprised to see a yellow.

 

Does he get hungry at night?

 

yes, but i leave food out for him. he's a grazer.
he gets up 4 times alone for peeing
plus however many to eat and drink
plus he can be fidgety, he's had sinus trouble/allergies lately, and who knows if he's got body aches (probably)
plus his hyperthyroidism was high recently (i've upped his meds)

seriously i swear i have aged so much this past year, from worry and lack of good sleep, which makes me eat more, so i've gained weight. i'm one hot mess. i so hope we are onto something now with his dosing, and that other problems (kidneys) stay at bay for a bit at least.

 

Yes, cross fingers, Jen. I read another note somewhere about hyperthyroidism causing insulin resistance. I hope you can find the fortitude to keep putting one foot in front of the other for Mr. B.

 

yes. he's has hyperthyroidism for a few years, and its true there seems to be general concensus that it makes diabetic regulation more difficult, even if the thyroid levels have been well maintained. also i have been told that the reverse can be true as well - that having diabetes can make hyperthyroidism harder to regulate. so we've got quite a bit going on.

 

You certainly do.

 

Looks like you're making progress, Jen! I'm sorry Mr B's other illnesses make things so complicated But we're all here rooting for you!

 

Thank you!

Thank you!



We had a stinky pmps tonight i dont understand but we keep trying.

 

You know... Could be oh look a squirrel syndrome!

I know its tough and you are exhausted. You've done a wonderful job so far...you've got this!

 

I appreciate the support but i'm not so sure

This is how it goes. Looks like we're getting soemwhere, then it all goes off the rails

These reds make no sense to me. I start to go insane when he's this high. His legs are bad on a good day, but in the reds he's really lame.

I cannot express in words how crazy this disease has made me over these 14 months.

 

He seems to have long spells of pink and red at a dose then yellow and blue poke through at the same dose. That suggests prolonged bouncing to me. Just an observation.

 

I'm sorry Mr B's numbers are high again, Jen. I don't know enough to give advice, but I do have a big virtual hug!

 

I dont inderstand this at all. Got home and tested him at +10
He's drinking tons and peeing oceans
I dont understand at all. Lower dose insulin isnt enough. Increases dont seem to work either.

 

I think you're up against his hyperthyroidism making him insulin resistant. I suggest you keep moving up methodically so you accumulate data in the 5+ unit range where you keep it simple and dose only every 12 hours and you hold a dose for several cycles. When you were at that dose level before you were trying a different dosing regimen and it might have jumbled him up.

 

I think Kris is right. He has underlying issues which make his big picture seem so frustrating and complex. And drive you - rightfully- crazy. Remember that breathing thing. You are doing the very best you can and he has made strides along with those setbacks. A slow, steady increase has improved his levels before. It most likely will again, just keep after that moving target.

I know we have suggested it before, but maybe make a list for your health as well as his. Walks, breathing, time out with people - whatever relaxes you. You are keeping him safe. Make some time for you!

 

Thank you both. I'm hanging in there. Had a good cry last night. Trying to be kinder to myself. Its not easy. I just want to see him feeling better. He's my little buddy. You know how it is.

Doingg a curve today. Might tell us something new.

 

I completely understand, Jen. Yes, be kinder to yourself - you're doing everything you can to help him.

 

Curve shows we're going back up after barely getting a yellow and its only +8. He will surely be in the 400's by +12, again.

Its not like he went anywhere near a healthy number that might freak him out into a bounce.

I know his thyroid may be to blame for all the crap luck we've had getting him regulated over a year now but i keep looking for a pattern, a way to at least get him into a better range of numbers.

Ideas anyone about today and how to proceed? I was hoping to do 12/12 but maybe i need to dose earlier. Clearly the insulin is wearing off as we speak.

 

I say stay the course and wait until +12 to give him 4.8 again. Your goal is to get into higher dose levels very systematically. I don't know if you've seen another cat on the ProZinc forum called Satan (Chuck). He didn't budge much out of high numbers until he was in the 5.4 u+ range.

 

Looked at the curve data again and if it finishes up as it began, it's a pretty typical PZI smile curve with definite +6 nadir that's obviously lower than PS. If it was some random curve I'd say decent response but dose needs to increase.

 

Thanks for that kris. I stayed the course. Mr b surprised me by hovering! I actually for a minute wondered if maybe i should lower tonights dose but i didnt.

Will see what the next 2 cycles bring on this dose.

Yes i have looked at satans ss and he boggles me just as much as mr b!

 

Good call to keep the dose. He needs a bit of pressure going forward, as does my guy. Yes, Satan's SS shows that he's a real conundrum. His owner, @StephG, is doing really well trying to head him off at the pass.

 

Our cats must be in cahoots together!
I've gotten to the point of googling acupuncture and acupressure for cats! Didn't find much that I think would help. I'm desperate to help him. I've tried to get him to exercise more but he's skinny on top of all this so we can't do too much. He needs to put weight back on- muscle and fat.

 

Its so awful isnt it! We tried acupuncture but it had no obvious results. I wont poopoo it though, as i'm sure some cats benefit, and i've had it myself to good results.

Its a wild ride this diabetes!

 

Stick with the plan, Jen. He did well yesterday, all things considered. I certainly don't poo poo acupuncture because I go once a month and find it to be supremely relaxing.

 

For all three of you - in the challenging group - it is great that you can support each other. And try to keep the big picture in mind - you are doing the very best you can. The first time I heard this, I had such an AHA moment: These kitties have no idea they are sick and causing you such stress. They think they have a great life - lots of attention, great snacks and food, a soft lap and warm place to sleep. I am positive they think they have all the important things in life.

 

Jen, I'm thrilled to see those yellows from yesterday. Your systematic approach is paying off slowly but surely. I see a note in your SS that you don't understand the reds. They're bounce numbers. Mr. B. is a somewhat bouncy cat but nothing to rival Hermione, Chuck, Phoebe or Teasel and I certainly don't mean to minimize the stress/worry it causes you. Your challenge with him I think is to carefully find the dose that will counteract his thyroid and kidney interference. And there is a dose range that will do that.

 

Thank u. I have guarded optimism.

He has been restless lately which is making it hard to celebrate these better numbers. I dont know whats bothering him. I dont know if he might be in pain or uncomfortable or what. I hate having to bring him to vet again but might have to. He's not really sleeping much, not taking long naps. He often looks distracted. Im worn out. Dont even want to get out of bed. I just keep crying.

 

You've mentioned arthritis in your signature. Do you treat it? My mom's old guy (16) does much better when he's on pain meds.

 

We've tried adequan which was hard to tell if it helped or not. Dasuquin didnt seem to do anything. What dors your mom use?

 

Just checked with her. It's gabapentin 50 mg/mL of liquid and she gives 1 mL BID with food. So it's a pain killer (usually used in people for neuropathic pain) and not a joint supplement like Adequan. Her guy is also hyperthyroid and has methimezole for that AND he's on "kitty Prozac" for anxiety induced hair pulling. "Special needs" kitty ...

 

Would you mind starting a new thread, Jen?

 

Thanks. We had used gabapentin earlier this year. Again it was hard to tell if it helped, and he had a lot going on, had a lot of mysterious facial twitching. We went to neruologist and all. What a nightmare waste of time.

Turns out the twitching only went away after we stopped lantus

Its hard knowing whats wrong and what might have helped in the past but was masked by something else. Maybe we can try gaba again and see.

Its confusing to me that this behavior has kicked up just within the past few days. Always when i anticipate he should be feeling better with better numbers but instead he acts less happy, less comfortable, less relaxed.

Maybe its the purina dm food, which i started to see if it would somehow help his bg, and because i wanted to prove to the vet that no it doesnt help and to get her to shut up about damned useless prescription food. Dm has artificial crap in it, because you know artificial stuff is so good for animals (sarcasm), and is full of chicken of course (cheap meat). Well chicken in the past made his ears and face itchy, so he hadnt eaten it in years until he got diabetic and we went on rx food (hills md which of course is awful for diabetics).

Anyhoo i've stopped the dm, which means he'll probably get constipated again. Its just fun all around here.

If he doesnt act better soon, i'll be dishing out more money and putting him through more tests. Sickening,

 

I've read about lantus causing twitching and hyperaesthesia is some cats. Teasel and his sister are both prone to attacks of hyperaesthesia, his sister more so. When Teasel was on Lantus it didn't seem to be any worse. His sister also has to eat hypoallergenic cat food or she breaks out in nasty looking crusty lumps on her face.

I'm sure you've tried pumpkin for constipation. Any positive effect? My mom's old guy also needs that to keep him functioning.

Might not hurt to give the gabapentin a short trial again without lantus to cloud the picture. Some people switched to levemir because of the issues with lantus and found it helped a lot. I'll bet the last thing you want to think about is another insulin ...

 

I copied this from another thread. It was in a post by a person who had a kitty with IAA and acromegaly:
" There is a dose for every cat that starts to move their numbers" @Wendy&Neko
Those two conditions have a huge impact on dosing as you know. You'll find the dose that starts moving Mr. B.'s numbers, Jen.

 

Our internet service was out for 24 hrs. Catching up now.

Mr b is peeing and drinking an awful lot today and seems off. More off than usual. Talked with vet to seee if subq fluids might be a good idea. She said cant hurt. I'm holding off on gaba for the moment. Dropped off urine sample to see if proteins there. Vet isnt so sure now about the early kidney disease that the other vet said. The urine should clear that up.

I dont think he'll eat pumpkin. I think we've tried that before.

Not a great day.

 

Complicated ...

 

I mix the pumpkin in my cats food. Works like a charm...they have no idea it's there and poops seem to be bigger these days. Worth a shot?

 

How do you keep the pumpkin from going bad before using the whole can? How much do you use each meal? Thanks

 

I put a can lid on it and keep it in the fridge. I haven't noticed any problems with it. I mean, I keep an eye on it to make sure it doesn't look or smell funky, but no problems so far.

I give about 1/4 tsp twice a day (just add it to each meal). However, I use it just to bulk up poops so you may want to ask on Health about constipation doses for it.

 

My mom does this for her cat and she measures out the individual daily "doses" of pumpkin into the sections of an ice cube tray and freezes them.

 

We're going to see the vet today. He's been staring into space, pupils seem more dilated than they should be, this along with all other problems. Still drinking and peeing tons, hanging out at the water bowls. had that rotten red last night. I'd test him now but we're at +10 so its kinda late anyways. I cant believe how hard we've tried to help him only to see him get worse. Its a nightmare. He's not a happy boy.

 

Odd - staring into space with dilated pupils is often a sign of hypo. I'm so sorry this is so difficult, Jen. Let us know what the vet says.

 

So sorry to hear he's feeling poorly Jen. Will be sending healing vines all day. Update us when you can.

 

Interesting morning. Took a +3 for pooops and giggles and was shocked to see a blue. Got worried. Didnt end up going to vet. He's green now at +4 .

What happened:

http://www.felinediabetes.com/FDMB/threads/108-at-3-had-a-little-scare-but-ok-now.169929/

Need thoughts on how best to dose tonight. 5u is looking like too much.

 

Strangely enough I was on the right track with this, Jen. I missed the drama because I was out at an appointment this morning. I see that Mogs gave you excellent guidance. Yes, a dose decrease tonight but not too large a decrease because you're getting some traction right now. The 99 was scary low compared to Mr. B.'s usual numbers but not generally regarded as hypo. However, he might well be extra sensitive to low BG. I think two things are in order:
1. dose decrease to 4.8 u or 4.6 u if that's more comfortable for you;
2. frequent testing today, this evening and tomorrow if you can be at home.

The 5 u dose might be that glass floor breakthrough I've mentioned before. If so, he'll be more insulin sensitive going forward. The low today might also make him more sensitive. His numbers could be erratic in magnitude and timing in this transition phase. Mr. B. isn't a huge bouncer and that's a good thing.

This is really good but stressful at the same time. Test often and post. You need a full picture of what's happening.

 

P.S. A new thread would make it easier to find your most current posts.

 

Thanks! I understand what you're saying. What a day. I'm wiped.

I was looking back through mr b's journal and his mood seemed best when he was on 4u. I know that might seem unreliable, but even looking at the numbers at that time for some reason i failed to get mid range readings. Maybe i'm being an idiot but i'm tempted to drop down to 4u. His nadirs might have been good at that dose we dont know, plus it wa right after i did that wacky 8/8/8 dosing so he was recovering from that at the time.

I dont know. I want to take your experienced advice but i also want to go with my notes on his mood at 4u. Due for shot in an hour. I can test tonight but tomorrow is out.

You were on track with that hypo reference! He wasnt hypo but he was feeling like he was, i think. And indeed he might have gone hypo, and/or his body was dumping glucose to keep him from going hypo. At least now we have more info and i know what that looks like.

 

By all means go with 4 u. You have to feel comfortable with what you're doing. If the numbers are higher than you like tomorrow, you can slowly increase from there. It could be that 4 u will give a bigger drop than before because of his low number today. Don't give up hope!!

 

I agree. You now have another tidbit of info at your disposal.

 

Thanks kris! Will start new thread next entry.

 

Saw that black on your SS. Now THAT'S a bounce!! He doesn't usually go this high so it seems that the low BG was quite a jolt to his system. This doesn't mean he won't be insulin sensitive tomorrow - be on the lookout for that. This is all new for you so data is essential.