New here. Diabetic since May 2015 Need Advice

Discussion in 'Prozinc / PZI' started by Damsel, Sep 28, 2016.

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  1. Damsel

    Damsel Member

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    Sep 26, 2016
    Hello;

    I have posted an introduction post and now am not sure how to start here. I have so much to say and don’t know how to present to you 1 year and 4 months worth of history in a concise message. Until I can get my spreadsheet converted to yours, I’m going to zero in with the chain of events since starting ProZinc at the end of August.

    I have two cats; one is diabetic, Morgan.

    He is 8 years old, (very cute and sweet), diagnosed last year, May of 2015. Started on Lantus, went up to 7 units; rarely got out of the 300’s. Numbers hardly changed and in August started going into the 400’s.

    Started ProZinc on August 29, 2016.
    He has never been regulated. I'm told he is a "healthy diabetic". Has had full blood work done twice, last in November, 2015.

    Since diagnosed, I have tried relentlessly to convert him to wet food. He refuses no matter what I’ve tried. For the past year, I would put 45 minutes into many mealtimes sprinkling freeze tried treats, toppers, anything healthy to entice him. He is not interested. He is eating Young Again Zero mature. Daily, I continue giving him some canned foods. Occasionally he licks or actually eats about a teaspoon of canned food (Nutro soft chicken loaf).

    I'm desperate for guidance. My vet wants me to increase to 3 units again, but we had an incident last week and I need advice before I do something my non-diabetes-educated instincts are telling me not to do.

    On August 29, 2016, my vet converted Morgan from 3 units Lantus to 3 units Prozinc.
    First off, I test at home. On 8/29, Morgan’s BG started at 440. The next three days, it started coming down. On 9/2, I did a preshot test: 159. I didn’t want to give a shot. The vet told me two hours later to drop down to 2 units and still give a shot. By PM shot time, he went down to 101. I did not give a shot.

    The next morning on 9/3/2016, preshot test was 230 - Gave 2 units .

    By evening shot, preshot test was 400. – Gave 2 units.

    The next 3 days, the preshots for AM/PM were: 314/208; 171/191; 233/195.

    On 9/7/ his 7:00 AM preshot was 63. I did not give a shot and called the Vet. The vet wanted me to test every hour and report back to him. Next hour, 8:30AM BG was 71, then at 9:30 it was 113. Per the vet, gave 1 unit. Same day BG result at 2:37 pm BG was 304. Vet said we should have stayed with 2 units even though his BG was 63. Two days later, AM Preshot BG was 395; went back to 2 units. Vet told me not to test for two weeks. He said I was going to drive myself crazy. (Too late for that.)

    Sept. 21, 2016; preshot was BG 395. Vet told me to go to 3 units. This is when the incident occurred. I could kick myself for not doing a preshot, but on 9/22/2016, AM and PM shot times, I gave 3 units. Around 11:00 PM, I realized Morgan hardly ate anything (after eating like a mad man for weeks, I wasn’t really checking). He was very lethargic. I tried putting food in front of him and he wouldn’t even look at it. He was lying down, but with his chest and head upright. I took BG, it was 124! (The way he was acting, I was afraid it was 30.) This is three hours after his PM shot. Long story short, he was ok; I kept an eye on him. He woke up normal. I had to play games with his food, but he ate more than the day before. Preshot BG test that next morning was 178; I went back to 2 units. BG later that day at 2:00 pm – 216. Next day preshot BG test was 473 and has stayed in the 400’s.

    Now, my vet wants to go back to 3 units. He wants me to do preshot tests and 1 mid day test (as of yesterday) for the next couple of days and report back to him.
    I haven’t increased the dose from 2 units because I’m afraid he will have another “episode”. What does all this bouncing of his BG mean? It looked like finally, his numbers might actually come down and I was hoping, stay down, but instead they’re higher than ever?

    Thank you.
     
  2. TempestsMum

    TempestsMum Guest

    Hello and welcome! There are lots of friendly people on here who can give you dosing advice and I'm sure given time and patience you will get kitty regulated! :)

    I have a question mostly out of curiosity :) when you give your shots they are always at the same times? 12 hours apart?
     
  3. Damsel

    Damsel Member

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    Sep 26, 2016
    Hello! I've been patient for 1 year and 4 months and keep renewing my patience daily! :bighug:
    Yes, shots are at 7:00 AM and 7:00 PM. I have been very diligent about being on time. He's worth the stringent schedule.
    Thank you!
     
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  4. TempestsMum

    TempestsMum Guest

    :bighug: I really do belief if you follow the advice on here you will see big changes - the folks on here helped me and Tempest was in remission in 4-6 weeks so I have every confidence in the advice given. Hoping you find the same even if it takes a bit longer than me.
     
  5. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    Hi and Welcome!

    It does seem like the ProZinc works to bring down his levels, which is great. But it seems like he is bouncing all over from highs to lows. Bouncing is when their body perceives a blood glucose level lower than it is used to and releases extra sugars to bring the level up. Then the next test, and sometimes the next cycle is higher than it would have been, without those natural sugars. Sometimes they clear a bounce in a cycle, sometimes it takes six cycles.

    And anytime you get a nadir 50 or under on a human meter or 68 on a pet meter (5-7 hours after the shot) it is a good idea to lower the dose. If you get a pre shot too low to shoot, because of a longer than usual cycle or a low nadir and a slow rise, it may be wise to drop the dose.

    If he were mine, I think I might do a restart with one unit. Get a pre shot test always and a nadir when ever possible. Hold the dose for a few cycles and see what he looks like over time. If his pre shots are in the 300s and his cycle is sort of flat, increase by 0.25 or 0.5 on a cycle when you can monitor. Slow increases may give you a better picture of how the insulin works for him. If you want, post here daily and give advice on your dosing.

    And I would set up a spreadsheet so we can really see his numbers. It is so easy to see the patterns when they are in the color coded sheet. Here are the directions:

    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    Take a look at other people's spreadsheets and see how they are dosing. Have you seen the Protocl and Beginner's Guide for ProZinc? They are in my signature in blue.
     
  6. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    I'm with Sue. I'd do a restart an see if we can get in better numbers. We generally increase in smaller increment s so it may be that you've jumped past the ideal dose.

    We'd love to help! Let us know what questions you have. :)
     
  7. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you, Tempests Mum. That is a great testimony and it definately gives me hope! When Morgan's numbers went into the 100's and then 63 & 71 so early into changing insulins, I felt we were on the right track.
    I'm very happy for you and Tempest. I'll fall over if we have such a happy result! Thank you too, for the well wishes!
     
  8. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you, Sue and Oliver, and Rachel for the advice. I read your comments last night, so this morning, I took a pre-shot. It was 342.
    Then, per your advice, I lowered Morgan's dose and gave him 1 unit.
    I don't have a lot of time today or tomorrow, but I will work on learning the lingo and download, learn and transfer my numbers onto your spreadsheet.
    Do I continue to post results and my spreadsheet here in this thread?
    Thanks again for everything. I feel like a weight has been taken off my shoulder.
     
  9. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    I can't access your apreadsheet. It takes me to goggle drive. When you get it set up, choose Share with Anyone with the Link. Then Publish to the web will give you an URL. Copy it and paste it in your signature.

    Yes, continue with this thread until you get things set up. Then, if you want, post daily with his numbers. You can do that on a single thread until it becomes too long, or start a new thread daily - your choice. If you ever need help right away, post here and on Health with a title that tells what the issue is and what you need.
     
  10. Damsel

    Damsel Member

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    Sep 26, 2016
    Hi Sue and Oliver;
    Thanks for the response and information. Not sure what I'm doing, but I made a second attempt; hopefully, this time it was a success.
    Next challenge will be finding it again and transferring my data.
     
  11. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    No, not yet. Tell me how you accessed it and what you've done.
     
  12. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you for checking and letting me know. I was naming the URL link incorrectly. It should be there now. Not very happy with this evening's test....... This is the highest number yet.
     
  13. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    There it is! Great job getting it set up.

    It looks like 2 units may have been a good dose for the higher preshots but maybe too much for the lower ones.

    It may be that one unit isn't enough but it's hard to tell without the that midcycle number. If he was high and flat, then the dose needs to be increased. If he dropped in the middle, the black could be a bounce. Can you get a curve this weekend? That's when you get a test every 2 hours. That would let you know when he starts to drop and how much. If he needs an increase, then we suggest increasing by 0.25, hold 3 days or so, getting a nadir whenever you can.

    This process is about gathering data and interpreting it.

    In general, we think a cat is regulated in they are in the mid 200s at preshot and low 100s or double digits at nadir. But not below 50 on a human meter or 68 on a pet meter. That's the first goal. Then you start to fine tune the dose.
     
  14. AJHJ

    AJHJ Member

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    Aug 18, 2016
    Looks like it's working now.
     
  15. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you, Thank you!
    I work from home, so I'll do a curve tomorrow and post the numbers as I go along.
    I never knew what conditions needed to be met to be regulated; now I know thanks to you!
    Your guidance is really appreciated.
     
  16. Damsel

    Damsel Member

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    Sep 26, 2016
    Hello;
    Did the curve yesterday. AM presot 321; 401, 381, 443, 393, 336 PM preshot 428.
    This morning's preshot was 363. It's on the spreadsheet. So, I guess I should stick with 1 unit and monitor for a few days?
     
  17. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    That is pretty flat and high. How about increasing to 1.25 and be sure to get a nadir? My thinking is that past cycles two units looked a little too high, so maybe somewhere between one and two. Start with 1.25 and then if not much movement after a couple days, 1.5

    Great job on the curve!
     
  18. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you. Doing a curve on a work day makes for a very busy day!

    OK. Tonight I will increase to 1.25; I will try to get a nadir this weekend; if not, then Monday.

    Thanks so much for your help!!!!!
     
  19. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    The safest way to increase is to do it on a cycle you can monitor - at least get a few midcycle numbers. If you won't be around, I think I'd wait to increase on a cycle when you are.
     
  20. Damsel

    Damsel Member

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    Sep 26, 2016
    To make sure I completely understand, you're saying I shouldn't increase unless I can get an afternoon BG. I give his shots at 7:00 AM & PM, so I shouldn't increase the insulin unless I know that day, I can take his BG around 1:00 pm?
    Also, not sure I understand what defines a cycle; a 12 hour period from the AM shot to the PM shot?
     
  21. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    Aug 9, 2015
    Yes a cycle is a 12 hour period from one shot to the next
    Sue is saying that it is safest to increase when you will be available to get an afternoon test - or how about on a Saturday night, you could shoot at 7pm and get a test at midnight or 1am? Would that work?
     
  22. Damsel

    Damsel Member

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    Sep 26, 2016
    Ok. Thank you. I assumed that was the definition of a cycle, but thought I should make sure.
    I'll do the increase tomorrow morning and make sure I'm around for the afternoon test.
    Thanks again!!!
     
  23. Damsel

    Damsel Member

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    Sep 26, 2016
    Yesterday, Sunday morning, I increased the ProZinc to 1.25 units. Morgan's 7:17 AM Preshot was 392; at 1:45 PM, 315 and then evening Preshot was 415. This morning, his preshot was 437. I was so encouraged yesterday with the 315 nadir; then it went up. I'm still learning, but thinking this was a bounce from the 315. So, pursuant to your previous instructions I'm thinking I should stay with the 1.25 units for two or three days full days and then increase to 1.5 on Wednesday if the numbers don't come down.
     
  24. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I think that's a good plan. There could be a lower number hiding mid cycle somewhere that is causing a bounce. It'd be nice to know that. Just to be sure, could you try for some other numbers - maybe +5 during the day and a nadir at night sometime, before the next increase?
     
  25. Damsel

    Damsel Member

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    Sep 26, 2016
    Can do. I'll try for a +5 tonight and then again tomorrow during the day.
    Thank you.
     
  26. Damsel

    Damsel Member

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    Sep 26, 2016
    Yesterday's AM Preshot- 437; PM Preshot - 387; 5 hours out from PM shot: 362
    Today: AM Preshot 363; +5 hours - 338; +10 hours - 340, PM Preshot: 369 - All on spreadsheet
    Tomorrow AM, will increase to 1.5
     
  27. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    That sounds like a good plan. High and flat curve = dose increase
     
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  28. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Hope you can get a mid cycle test to see what is happening and if still high and flat , good luck with the dose crease.
     
  29. Damsel

    Damsel Member

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    Thank you for the responses! This morning's Preshot was 382 - increased dose to 1.5 in AM. Got BG at +8 = 317, PM preshot was 414.
    These numbers are practically identical to October 2nd when I increased the does from 1 to 1.25. Hmmmm
    (Oct 2nd was: AM preshot 392; +7=315; PM preshot 415)
     
  30. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Nothing exciting yet. I still would hold this new dose for the 6 cycles before increasing.
     
  31. Damsel

    Damsel Member

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    Ok. Thank you. Your support is awesome! I haven't input all my numbers from May 2015; not sure it's necessary since we've switched to ProZinc on August 29, 2016. From May of 2015 until June 30, 2016, we never did Preshot tests so that data is unknown.
     
  32. Rachel

    Rachel Well-Known Member

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    I think what you have on the SS is fine. History is important but you have a month or so on there already.
     
  33. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    I know that it is hard to be patient, but now that you are on the board, he will be on the best path to regulation
    The Young Again Zero Mature is very low in carbs - so while you do need to keep working on finding that magic wet food Morgan will eat to get more water into him, at least he is on a low carb food. My Murphy was dx 8/2015 and is still not regulated, but he is certainly healthier in many ways than he was pre-diabetes.
    Hang in there :bighug::bighug:
     
  34. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you Rachael. That's good news! Transferring that data would be alot of work, but if needed, I would do it.

    Carol, thank you for the pep talk; I needed it. I checked out Murphy's spreadsheet; wow, his numbers certainly have improved! I'm waiting for that day. 1 year and 5 months of roller coaster emotions has been difficult. It definately helps encourage me to see my cat is not the only one struggling with numbers and that others were in similar circumstances and saw the light at the end of the tunnel!
    Regarding food, I'll keep trying with the wet food. Lately, Morgan doesn't want to even lick the Nutro I give him at meal time, but then he'll eat his brothers food (Nutro & Fancy Feast Classic) out of his brother's dish (in another room). It's funny, but if Morgan feels good about eating his brother's food, so be it. I'll have to install a surveillance camera at the food dish to make sure poor Reilly gets his share of wet food because Reilly actually loves his wet food! Lol
    Thanks again for all the support! Keeping my hope!!:cat:
     
  35. Damsel

    Damsel Member

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    Yesterday's AM Preshot was 384; PM Preshot, 346
    Today's AM Preshot 343; +10 was 376 and PM Preshot was 359. This is at 1.5 units. I was unable to get more numbers. This is day 3 of 1.5 units.
     
  36. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Will you be around to monitor if you increase tonight or tomorrow? If so, I'd increase to 2 units.
     
  37. Damsel

    Damsel Member

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    Sep 26, 2016
    I'll be in and out tomorrow so I could increase in the AM at 7:00 and check once or twice in the afternoon. Sounds like a plan.
    Thank you!
     
  38. Damsel

    Damsel Member

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    Sep 26, 2016
    Hello. I increased to 2 units on Saturday, 10/8/2016 and just was able to update my spreadsheet.
    I was happy to see some 200's. Should I stay with 2 units for another day or two or increase slightly?
    Thank you.
     
  39. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I think you can increase; he has room to drop. Raise by 0.25 on a cycle you can monitor. Yes, very nice to see some yellows.
     
  40. Damsel

    Damsel Member

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    Sep 26, 2016
    Ok. Thank you. I feel like I have a fairy godmother. I type our progress and presto, chango, I receive a response.
    Thanks so much for being there!!!!!!!!!!!!!!!!!!!! I will increase.
     
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  41. Damsel

    Damsel Member

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    Just updated my spreadsheet. Totally confused......
     
  42. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Got some yellows with that dose, but it looks like he needs more. Maybe increase to 2.5 on the first cycle you can monitor.
     
  43. Damsel

    Damsel Member

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    Will do. Thank you!
     
  44. Damsel

    Damsel Member

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    Three days at 2.5; still high. Spreadsheet updated. Thinking to to 3 units?
     
  45. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Yes, I'd increase on the first cycle you can monitor.
     
  46. Damsel

    Damsel Member

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    Sep 26, 2016
    Ok. Thank you. We'll start 3 units tomorrow.
    Have a nice night!
     
  47. Damsel

    Damsel Member

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    Thought I'd give an update. I just updated my spreadsheet. Did a "curve" on 10/20 and was thoroughly discouraged with the numbers. Morgan is back to the same pattern of stagnant numbers like he was with the Lantus. My vet called me on Friday saying he was leaving for vacation for a few days; he wants to discuss Morgan's situation with the other vets in his clinic for the next best course of action. Morgan is losing weight and is giving me a really hard time about eating his young again zero food now. He was eating a little of the Nutro and Fancy Feasts, but isn't bothering with the wet again (nothing new there). All he wants is his EVO dry food which I've just been crushing and adding over his YA food to get him to eat, but he doesn't fool easy and will only eat a few EVO covered YA kibble and looks at me and cries. When I give him 2-3 EVO kibbles; he gobbles them down. I know the EVO used to be "pretty good" for a dry food, but then the carbs went higher. The EVO will increase his BG, but at the same time, he lost 1.5 pounds since 10/14!

    I increased his insulin .25 on 10/21 and honestly haven't checked his numbers. He's starting to run from me when he sees the dish with test "tools" and I feel like I hate making him go through this when nothing seems to change his numbers. His numbers haven't changed in 1 year and 5 months. Coming out of the gate with the ProZinc made a difference initially, but now we seem to be in the same pattern.

    My Vet said some cats and dogs are just resistent to insulin. He said that he has, in the past, mixed insulins. He said they referred to that as a "cocktail". I think he returns to the office on Tuesday, so I'm waiting to see what he has to say.
     
  48. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    I would get more aggressive with the dosing, if he were mine. But to do this, you'd need to test enough to keep him safe. Are you giving him a treat he loves every time you test? That is usually the secret to testing.

    You can increase by 0.25 every six cycles. His numbers aren't awful. They just need to drop some. But I wouldn't do it without regular testing.

    We generally don't think of high dose conditions until the dose is increased to 6 units or so. I have never heard of an insulin cocktail - it sounds like a volatile idea. Sometimes a vet will use R insulin in addition to the usual insulin to bring down very high numbers, but only temporarily, usually very carefully and usually only in an emergency situation in a clinical setting.
     
  49. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Hey there, so sorry that Morgan is running from you at test time. Have you tried a low carb poke treat to entice him a bit more? Poach chicken or YA makes zero carb treats that my gang ( dogs and cats ) love! It is so important to be testing because you never know when they are going to decide to drop like a rock.

    It would be really helpful if you can get some night time test in as Morgan could be going much lower at night ( a lot of cats do) and then bouncing upwards for the AMPS. Tests that would be really helpful would be to get a +2 to see how active the cycle is going to be. If it's the same number as the PMPS or lower then you'd need to test more to keep him safe. And a before you go to bed test would be great information also. If those numbers looks the same as the daytime cycle then insulin resistance could be a factor here.

    Perhaps what your vet was talking about was for you to use a short acting in/out insulin like Novolin R along with the Prozinc to help pull down the numbers. But, you would want to have guidance with that as it can be dangerous if given to high of a dose and bouncing could get worse. I used it with Bubba along with Lantus and had the guidance of two people in Lantus that are very knowledgeable using a bolus insulin.

    See about some more night time test too to fill in the pieces to the puzzle.
     
    Last edited: Oct 23, 2016
  50. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you Sue and Bobbie. I never thought about giving him a treat at test time; he likes the dried chicken and turkey treats so I'll try that. Neither cats like the YA treats unfortunately (I still have an entire bag).

    The weight loss has me very upset. He's been great up until lately. His weight was around 15 pounds pre diabetes; went to 19 pounds when getting 7 units of Lantus and as his dose went down (because his numbers were not changing), he slowly lost that weight and looked great for a while. Now, he's starting to look thin at 13.4 pounds. He is a big, long cat. He weighed 14 pounds when he was 2 years old. He is now 8.

    Ok. I'll test him tonight and try to pick myself back up and stay positive.
    Bobbie; did the dual insulins reduce Bubba's numbers? How did that work?
    Thanks again for your help.
     
  51. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    I am glad you brought the weight subject up again as I meant to say to please check for ketones as Bubba started losing weight when he was throwing ketones and he was only in the 200 range when that happened.

    What in a good weight for Morgan? And I am not sure why he gained weight while on Lantus unless you were feeding more? How much are you feeding? There is a formula for calories which is the ideal weight times 13.5 add 70. Using a 10 lb cat as an example: 10 X 13.5 = 135 + 70= 205 calories a day. then just divide up the amount of calories into the amount of feedings you are doing a day. ( I give Bubba 6 little meals a day but, I am home all the time and can do that and I have an autofeeder to use if I go out)

    Use Morgan's idea weight into the formula so if you would like to see him back at 15 lbs use that number.

    Yes, the R insulin in adunct to the Lantus helped us tremendously. It broke through the resistance and got rid of the ketones and gave the Lantus something to grab onto and started to get him into better numbers. This all happened in December of 2015 . But, again, careful guidance when using the R insulin in adjunct to the ProZinc under your vets guidance.

    Yes,stay positive, get more test at night, and let's review the amount of calories he is getting and rule out ketones and go from there . :cat:
     
  52. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you for the information. Very encouraging that the dual insulins got Bubba into better numbers.
    Morgan was good around 15 pounds. I have two cats, so it's difficult to tell how much food he's eating.

    My day is crazy, so I'll respond better later to your questions. Just wanted to quick go on line to check some other cat foods to try at the pet store. Still hoping to find some canned food Morgan will really like.
     
  53. Damsel

    Damsel Member

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    Sep 26, 2016
    It's been a little while since I posted. A lot is going on with work and computer problems, not much extra "living" time right now. Also, must admit, I feel like I'm cheating on my Vet too by coming here for advice.
    The update is that we were raising Morgan's units because of his high numbers. We got up to 5 units. Obtained a new bottle of Prozinc on 11/8 and gave Morgan his shot that evening. He was at 409 in AM, 411 PM.
    11/9/2016 I tested before his AM shot ---34! I tested again thinking it was wrong --38. Contacted the Vet; tested almost every hour. I updated his chart - he stayed low almost all day. I had a meeting in the evening, so last test was at 4:40 pm - 89- no shots on 11/9/2016.
    11/10/2016; 452; 330; 342. I wanted to lower his units to 2, but my Vet said 3 so he got 3 units in the AM & PM
    11/11/2016 - This morning -- 66. Contacted the Vet. He said to keep checking and when he gets to 100 give him 3 units.
    Either something is going on with Morgan, or this bottle is more potent for some reason. My Vet said a new bottle wouldn't do this, but????
    Anyway; I have a very busy day today. I wanted to quickly get this on the board; I'll check him again in the next few minutes. I'm praying he doesn't go over 100 because I cannot give him 3 units.
    He is eating and drinking like his usual crazy diabetic self when his numbers are high. His fur actually looks better than it has in weeks. It was beginning to look more oily than usual. He was perfectly normal on Nov. 10 also when his numbers were so low; eating and drinking like a mad mad. If anything, I'm feeling light headed.....
     
  54. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I would definitely not to give 3 units if he gets to 100. I would suggest not shooting under 180 and then I think reducing to 2 is a much better plan - if you can be there to get a nadir. If not, I might be tempted to dose lower.

    Several hypo episodes may have lowered his numbers more than usual. Or it may be the new vial. Or he may have reached his threshold and be requiring less insulin. Or he may be overdosed Any of those is possible. But the response is all cases is to proceed carefully and monitor and lower the dose.

    I know it is hard to go against your vet's advice, but your vet is not there to monitor him during the day. And I always think your gut is a good guide. Vets do find it hard to argue with " I was scared to give him more insulin".
     
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  55. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you Sue. I just tested again and he's at 63. Don't believe its a good approach to chase very low numbers; it concerns me for his health. I'm trying so hard to get him regulated so he can live and be healthy!!
    Morgan's ears are starting to look a little sore at some of the test sites. I was hoping to give it a rest and just do pre shot numbers for a couple of days, but I know I can't now. I'll test a little later and update the sheet.

    My Vet is very nice and has understood my fears. He believes the high bouncing indicates too low a dose so he wants to stay steady with 3 units for a week to let it even out. My non medical educated or experienced gut definately feels differently.
    Thank you again for your advise.
     
  56. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    This makes no sense to me. I know bouncing is a difficult and maybe disputed concept, but his explanation seems exactly backwards. If the dose is low, the numbers can be high and then the dose may need to be increased. But if the dose is too high, then the numbers drop low at the lowest point and bounce back up (because the body senses a lower number than it is used to and releases extra glucose) The difference can be seen in the cycle. A low nadir can cause a bounce; a higher, flat cycle can be too little insulin. Clearly Morgan is having lows and then bounces from those. But regardless, if a kitty drops into the 30s and 40s, the clear indication is that the dose is too high and sending him into dangerously low levels. MHO.
     
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  57. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Sue has given you excellent information on how too high a dose can cause low numbers and then a bounce into high numbers. Just to throw something else in here..you said you changed vials of insulin on Novemebr 8. That was right when the numbers started dropping very low. It is quite likely that the old vial had lost its effectiveness and was not giving the full effect. If this is the case then shooting the same dose on the new vial could very well out your kitty into a serious hypo. This is one of the first things the vet should have considered and the dose should have been lowered substantially. If the old insulin was losing its effectiveness you could have been only getting a small % of what the dose should have been.


    ETA Until it is known whether the new insulin is more potent the dose should be very conservative and then raised back up as necessary.
     
    Last edited: Dec 8, 2016
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  58. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I truly understand that you feel like you're cheating on your vet, especially if you like him/her. I felt the same way. I can tell you that my vet, who's excellent and is very willing to work in partnership with her clients, had no clue about bouncing happening merely because of a kitty body's "perceived" low BG or rapid drop in BG. She mentioned the Somogyi effect but thought that all overly elevated numbers came about because of a very low BG at some moment during a cycle. She was very much on board with doing a BG curve at home and stressed the importance of canned low carb food but never once mentioned testing before injecting.

    I've since had a long discussion with her about how I do things now, emailed her the spreadsheet and have her endorsement to keep doing what I'm doing. She's willing to order in ProZinc for me without seeing Teasel in the clinic and is there as a resource if I need her advice. Would your vet be open to a discussion about how you feel? It might set your mind at rest.
     
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  59. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I agree. I approach a new vial with caution and only start it when I can monitor.
     
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  60. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    I agree with Kris. Have you tried just having a chat with your vet about this board? Some vets are actually really open to this board and to you controlling things more at home. My vet mentioned home testing to me in passing...never encouraged it really. But when I came back and showed my chart and said I was home testing, she was all for it. Told me the only reason she doesn't press it is because most owners are so scared of the shots and so overwhelmed that she doesn't want to add more. :)
     
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  61. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you all for your input! Very busy day today, just got a break from work now to check him again. He is at 140 so, being almost 2:30, I feel justified in telling my Vet that #1 I missed when he hit "100" and #2 At 2:30 (he gets his shots at 7:00) I think it's too late in the day so I waited until the evening. Of course I'll test, but I don't care if he goes to 500, I'm not giving him 3 units.
    My Vet is very nice. These last few days we have corresponded via e-mail only, which means he is really, really busy. He is very good about calling me to check in; I'm hoping he'll call me so we can converse and get a feel for how set he is on my following his advice. Bad thing is he has been taking off on Fridays. Most likely he was not at the office when he responsed to my SOS e-mail this morning.
    We just started Prozinc on August 29th so that bottle was only 2 months; 9 days old! I always wonder about a new bottle and its potency.
    From my Vet's one comment on his e-mail when I said it seemed like the new bottle made a difference, he responded "the new bottle should not make a difference".
    I'm starting to think I should go back to 1 unit again depending on if he even goes up anymore tonight.
    I'll post my PM Preshot number later.
    Thanks again!!!!!!
     
  62. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    It is shot time and Morgan is at 193. My Vet did not contact me to see how things are going which makes me believe he is out of the office today.
    As you know, he wanted me to give 3 units once Morgan reached 100. Now he is at 193; should I skip tonight? Just give 1 unit or 1/2 unit? I'm not really sure what to do.

    Hi Rachel; I have not discussed this board with my Vet. He is actually "new" for me; but was highly recommended and a very popular Vet in our area. The Vet I had before pointed me to Binky's list and all the information that came with that. This Vet is very nice and down to earth, but somehow I'm not quite comfortable yet telling him I'm seeking advice elsewhere! I've gotta work on that....
     
  63. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    He is close to 200 which is usually our no shoot number, although with a pet meter, we usually look a little higher. Can you monitor tonight - maybe +2 to see if he is headed down and then around 5-7 hours after the shot to see how low he might be going. Do you have some gravy food in case he'd drop low?

    I think I might try 0.5 but plan to monitor. It is hard to decide how much to cut - much easier to increase based on your data. If it makes you uncomfortable to give any, skip and plan to figure out a dose in the am.
     
  64. Damsel

    Damsel Member

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    Sep 26, 2016
    I can check at +2, and then around +4 tonight, but I have to get up early so off to bed after +4. I think I feel comfortable with .5 units tonight and then see where he is tomorrow. Most likely he will be high tomorrow and then I'm thinking 1 unit to see where that puts him for the day after?

    Thanks again!
     
  65. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    If he is above 200 - especially nearer 300- one unit sounds good. If he is closer to 200, maybe stick with 0.5, since it will have worked well?
     
  66. Damsel

    Damsel Member

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    Sep 26, 2016
    Agreed; I feel comfortable with that. There is a caveat; however, at the last minute I drew .25 units. Couldn't shake the question "how potent IS this new bottle"? So, maybe that was worthless, but it was a compromise between .5 and skipping his pm dose. Guess we'll see! I'll post his numbers after I do them, but I won't post on anything here unless I have a concern. Thanks again.
     
  67. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    Always better safe than sorry. :D
     
  68. Damsel

    Damsel Member

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    Sep 26, 2016
    Absolutely! So; you may not be up anymore tonight, but I just tested at +4 and he is at 328. Now I'm regretting the .25 ; that it will just sky rocket until tomorrow....
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Just another data point for your SS. You can get back on track. :)
     
  70. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    So, if he is high today, I would still consider being somewhat conservative. Maybe one/1.5? My thinking is that you can move back up, if needed, based on the levels you get. But guessing how much less to give on a lower number is so much more tricky.
     
  71. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    You gotta do what makes you most comfortable. It's all good data if nothing else!
     
  72. Damsel

    Damsel Member

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    Sep 26, 2016
    Just updated the spreadsheet so you can see how we transitioned. Yesterday started with 2 units because he was staying high. This morning preshot was 336; just now, his preshot is 130. I hate to lose the momentum with getting some low numbers. Maybe I'll check again before I go to bed and if he goes over 180, then give 1 or 1.5?
     
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  73. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    You could try this but will it mess up your overall schedule? If you have the freedom to chase the number and dose when he is high enough, that'd be good.
     
  74. Damsel

    Damsel Member

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    Sep 26, 2016
    I have no life lately! :D I'll check again around 10:30. If he's still not up to 180, then no shot tonight and I'll stick with 2 units for tomorrow (assuming it will be high).
    Thank you!
     
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  75. Damsel

    Damsel Member

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    Sep 26, 2016
    Last night I checked at 11:00 pm which is +4; he was 249 so I gave 1.5 units. This morning, AM Test was 63; apparently I guessed too high.
    I see what you're saying about chasing the numbers and I really don't want to change his schedule or incorrectly guess a dose. It appears from looking at other spreadsheets, staying with the schedule means if his pre-shot is too low; then just no shot and leave it be (other than monitoring). Something is definately happening since starting the new bottle!
     
  76. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    So is this morning's number 12 hours from last night's shot? If not, your real amps will be 12 hours from that shot. If it is, then yes, a clear signal to reduce the dose.

    Just keep muttering "gathering data, gathering data". The good news is that the data has good numbers.
     
  77. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    You are correct; that was not an actual 12 hour snapshot since the previous night he got his shot at 11:00 pm instead of 7:00. So yesterday was No AM Shot; 63; 183 (at +2) 432 - Gave 2 units at PM shot.
    This morning, amps 243; gave 2 units. Quite surprised with the 243. This morning I started new bottle of test strips for Alpha Track - the code was 92, which I have not had a 92 bottle before, but I made sure I adjusted the code on the meter to 92. (Just talking out loud. Anytime something is new, it makes me a little paranoid that I may do something wrong).

    Yes; I will mutter "gathering data"; common theme here; thank you for the good advice!!!!
     
  78. Damsel

    Damsel Member

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    Sep 26, 2016
    Today: 243 amps - gave 2 units. +6; 105. Had to go out of town at 3:00 which meant I would miss his 7:00 shot (never did that intentionally before). Tested him as soon as I got home which is +4. His pmps is 117! These numbers are very surprising but I'm confused as to why he is drinking like crazy. I thought if his numbers would be lower than his symptoms would ease up?
     
  79. Damsel

    Damsel Member

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    Sep 26, 2016
    Just updated my spreadsheet. His bounces are now going in the 500's!! Should I stay at 2 units? I was thinking with some of the lows he's had this month, that perhaps 1.5 units would be better but these bounces are higher than ever!
    I pulled my back giving him his shot this wonderful holiday season, so I haven't been able to get additional tests; it's a challenge just doing the standard right now...
     
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  80. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    It looks to me like several things are muddying the waters. It looks like the .5 on197 was too little a dose. Then the skipped shot for the 118 created some higher numbers - likely both a bounce from that low and just going 24 hours between shots. If possible, next time, stall when you get a preshot too low to shoot. Wait 20 minutes without feeding - both to be sure the number is rising and nearer your target 200.

    If he were mine, I think I might drop to 1.5 and hold the dose several cycles (unless he is too low to shoot) to see if he settles down and has fewer highs and lows. If you can, post more often with your numbers and get advice.

    Ouch - back issues are the worst!
     
  81. Damsel

    Damsel Member

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    Sep 26, 2016
    I second-guessed that .5 dose at 197. My thought was that he was close to the "no shot" number and I didn't want to skip it all together.
    I like that plan to go to 1.5 for a few cycles.
    The back, yes. Trying to work today, but not very comfortable... I'll post more often; definately need the help! Thank you!
     
  82. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    My Vet happened to call after I posted the above post. He wants me to stick with 2 units and when I am tempted to skip a dose when he is under 100, I should give 1 unit. :nailbiting:
    Today, Morgan was at 377; 435 (got an extra one in) and 458. Unfortunately, he is not feeling well. Not sure what is going on. He had runny poop this afternoon and has tried to throw up a few times, with only a little liquid coming out.
    We are 1 hour after our shot time. I did not give him his shot because he has not eaten.
    He's sleeping right now; I'm hoping he'll feel better and then maybe eat a little, but only time will tell.
    Now what shall I do?
     
  83. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    It "sounds" like you are unsure about that advice. I think your instincts are good. 100is a normal number and giving one unit would certainly make me nervous. He would only have 50 points to drop before he was in hypo territory.

    I would see if he will eat - maybe make the food smell "good" by heating it up in the microwave, offering some off your finger, add a little of his favorite snack crushed on top. Also baby food without any spices can sometimes help their appetite. Did you change flavors recently? Maybe they didn't agree with him? Any other issues - different med?
     
  84. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Have you changed food recently? Is he getting Fancy Feast Turkey and Giblets? Some people are finding doesn't it agree with their kitties after an apparent reformulation. His recent numbers suggest bouncing is going on. Maybe give him a smaller dose if he decides to eat a little? You don't want too many missed shots when BG is high. Do you test for urine ketones?
     
  85. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

    Joined:
    Aug 9, 2015
    I do agree with Kris - he's high enough that I would be tempted, if he were mine, to give at least half his dose. Also agree to test his urine for ketones.
    Has he done this before (acted sick and not eaten or had diarrhea)?
     
  86. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    He doesn't take any meds. I didn't change food and he only licks the wet food. He only loves his dry food which is Young Again Zero, so i can't heat that! I tried giving him a treat; no interest. The wet I put out was the same for my other cat and he is fine. Thanks for the info on the Fancy Feasts Turkey though; I have a few cans of that here. He turned his nose up at the baby food the last time I tried. He's been eating like crazy lately and especially if I sprinkle FortiFlora so I sprinkled some on his food tonight and he walked away. I'll keep trying to get him to eat so I can hopefully give him at least 1 unit tonight.

    He has not been sick; however, he has been eating so much that occassionally he has partial softer stools. Today was outright liquid.

    I'm running out of Vets in my area! This Vet calls me and checks on Morgan's results which shows he cares. He's understanding my refusal to give 3 units as he recommended, but when I suggested 1.5 units he was pretty firm about 2 units when high and then 1 under 100, but to stop skipping shots under 100. I am not happy at all about being told to give a shot under 100.

    On a side note; I was watching my other cat, Reilly trying to clean Morgan earlier. He was cleaning Morgan's ears and it got me thinking. Since Morgan has been on insulin, Reilly got vicious toward Morgan and now Reilly gets Amitriptyline rubbed in his ear every morning. Morgan RARELY cleans Reilly, but what if he licked Reilly's ear with the Amitriptyline?
     
  87. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    Aug 9, 2015
    I am not sure about the amitriptyline - you might ask your vet
     
  88. Damsel

    Damsel Member

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    Sep 26, 2016
    Thought I should post that since my last post on Monday, around 10:30 pm (+4 PMPS), Morgan started perking up a little. He actually ate quite a few pieces of kibble so I gave him 1 unit at 10:30 since I couldn't shoot at his regular scheduled time. He woke up on Tuesday acting perfectly normal. He has been sneaking a little of his brother's fancy feasts chicken so I'm wondering if that was the problem. Kris mentioned a problem with the turkey, but I have the chicken opened. Maybe same problem? Always something to worry about! My spread sheet is updated.
    Also, I never responded to Kris' question about testing for urine ketones. I have not done that and honestly, it's not on my list right now. Some days it takes a lot of self encouragement to get me through all the cat issues here. I won't bore you with details, but suffice it to say that between Morgan's diabetes procedures and Reilly's behavior and poop problems (which I think is from the Amitriptyline), I'm working really hard to try to keep a good, happy disposition!
     
  89. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

    Joined:
    Aug 9, 2015
    :bighug::bighug::bighug::bighug: It's very hard this is a great forum to just vent - we all need to vent on occasion
     
  90. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    Yes! Thank you!!!! Just wanted to give an update on his health issue and went into a vent. Thank you for understanding. I'm hoping to keep my hair in tact!
     
  91. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    I updated my spreadsheet. His numbers are high and haven't been dropping anymore. Can't help but wonder if we should renew the ProZinc bottle every month. Tomorrow is one month since we started this latest bottle. My Vet charges $89 which isn't bad. I was paying $280 for the Lantus, so I would be willing to buy a new bottle every month if it helps keep his numbers down. Do you know if there are potency issues with bottles over 30 days old?
    Some good news; Morgan has been chowing down more wet food than usual. I've perused this website for food suggestions and tried Sheba Chicken Pate and a few Weruva seafoods (which he really likes, but I only give a little seafood) and now the Nine Lives chicken pate. He still eats mostly the Young Again Zero dry.
     
  92. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    Glad he is eating better! There is no way to know whether Lantus will work better or not. It is dosed completely different and will require nadirs frequently as the dose is based on the nadir not the preshot and the nadir like ProZinc, so be sure you get advice if you change. It will be very hard to work with if you can't get nadirs - I seem to remember you have trouble getting midcycle numbers?

    I think more data would help - curves when you can, nadirs whenever possible. It is very hard to know what is really going on. I think raising from 2 to 2.5 is a big jump, especially without knowing what is happening between preshot tests. I wonder if 2 wasn't working better in late November/early December and maybe a raise to 2.25 might have been a good idea.
     
  93. Damsel

    Damsel Member

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    Sep 26, 2016
    I think I worded that incorrectly. I don't want to go back to Lantus. It just seemed that a fresh bottle of ProZinc keeps his numbers down better and as I use the bottle and the days go on, the potency lessens and his numbers are higher. On November 9th, when I started the new ProZinc bottle, his numbers were going lower (although, out of the gate too low because the dose was too high). I'm wondering if it would be better to get a new bottle of ProZinc every month even though we don't use the entire bottle in a month's time.

    About the mid day numbers; I was running out of test strips AND pulled my back so I wasn't getting mid numbers. The back still hurts, but getting better. I will try to do more mid day tests. Can't do a curve yet, but will try to do one very soon. I get what you're saying. The mid day number could be lower than I realize so it's important to do the tests.

    Thank you!!!!!!!!!
     
  94. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    Sorry, I misread it. ProZinc should definitely last longer than 30 days, if kept in the refrigerator and rolled before giving. I would guess a new bottle might be a little more potent than an old one (3-6 months old maybe) but I wonder if the dosing is the issue rather than the insulin?
     
  95. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    He's in hiding this afternoon, so I was unable to do an afternoon test which probably is what you need before can answer my question, what dose you recommend?
     
  96. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    My ProZinc lasts 2 months no problem. I'm careful storing and handling it of course. Your vet is charging a really good price for it.
     
  97. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I agree with Sue that you might need a higher dose to get better numbers. Quite likely the ProZinc is still potent enough. You were way up at 5 u when you had the hypo run of numbers. After that, he might have remained insulin sensitive for a period of time, hence the better numbers on a lower dose. Recently, 2.5 u has left him in red for AM/PMPS. I suggest raising to 2.75u for a few (3 - 4?) cycles to see how he does. You'll probably have to get at or above 3 u to see more blues.
     
  98. Damsel

    Damsel Member

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    Sep 26, 2016
    Thank you. Yes; I thought $89 seemed very fair. What a relief after the Lantus cost. I'll try to get a mid test today and then raise to 2.75. I didn't get to update the spreadsheet yet, but he was in the 400's yesterday and today at AM/PMPS.
    Also, I am very cautious about keeping the insulin in the refrigerator; however, one day last week I realized I left it on the counter for 4 hours! It was not near heat though.
     
  99. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    The aggression may have been due to Reilly detecting that Morgan's got an illness (e.g. Morgan may have a different scent). I had a similar issue and I had to keep my civvie in a different part of the house otherwise she would attack Saoirse.

    Good sites for research on meds include drugs.com, marvistavet.com, and peteducation.com. Here are some links:

    https://www.drugs.com/sfx/amitriptyline-side-effects.html (even though it's written for humans it can be a help in identifying med-related problems in pets, too - especially if they're very med-sensitive).

    http://marvistavet.com/amitriptyline.pml

    http://www.peteducation.com/category.cfm?c=2 1457

    It might be worth your checking out a new product - Feliway Friends diffuser; it's supposed to help reduce aggression, etc. I used it in combination with the regular Feliway diffuser for Saoirse and the combo was very calming and reassuring to her.


    Mogs
    .
     
  100. Damsel

    Damsel Member

    Joined:
    Sep 26, 2016
    Just posting that I updated the spreadsheet. Had a shocking high number last night; increased to 2.75.

    Mogs, thanks for the links for meds for Reilly. I just received three new Amitrptyline pens but have been wondering if we should try something else. I think his poop problem is from the Amitriptyline. Also, it seems to work better some days than others. We have peace and quiet for several days and nights in a row and then he starts stalking and attacking again. Although it is no longer vicious attacks and I can easily break it up and separate them for a while. For that, I am thankful and so is Morgan.

    I have some Feliway spray, and considered the diffuser; however, I seem to get an allergic reaction to it. I am not really allergic to anything so it's strange, but it gives me coughing fits and I can't breath so I decided the diffuser probably wouldn't be a good idea. Who would take care of Morgan? :woot: Thank you, very much. I will check these links out for a possible change! Love this forum. All of you are so nice, infomative, encouraging and full of great advice and information!!!!!!!
     
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