Roller Coaster Readings

Discussion in 'Prozinc / PZI' started by AmFon, Feb 17, 2018.

  1. AmFon

    AmFon Member

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    Feb 17, 2018
    My cat Ringtail (male, age 5 years) was diagnose with diabetes in Oct. 2017. He was put on .5 of ProZinc. His vet now has him up to 4.0 units twice a day. His overall health is good: stable weight, lots of energy, shiny coat, sassy cattitude. ( : But his numbers have more ups and downs than the Olympic HalfPipe event! Our vet advised me not to give the injection if he reads below 200. I've seen readings as low as 36, as high as 600+.
    Here is a 5 day sample: Feb. 11- AM 177 PM 252 Feb. 12 AM 431 PM 474
    Feb. 13 AM 87 PM 536 Feb. 14 AM 362 PM 66
    Feb. 15 AM 600+ PM 441

    I am feeding FancyFeast Classic Pate twice a day, as well as 9 Lives canned tuna occasionally. I would appreciated any advice or input on the numbers, as well as feeding advice. Should he be fed smaller meals more often? Should I feed him "home-cooked" instead? HELP!!!
     
  2. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    The Olympic Half-Pipe is my new favorite event! Those athletes are CRAZY!!!!

    Welcome to our little Prozinc group!

    Fancy Feast Classics is fine, though I always recommend more meals during the day to helps stabilize BG. Just feeding twice/day leaves too much bouncing and diving in most cats.

    It sounds like he's likely on too much insulin, although it could be a couple of other things as well. Great job home testing and recording the data. We use a handy, color-coded spreadsheet to keep our data and it makes it super easy to find patterns in response and figure out what to do. Well, the spreadsheet is easy -- the cats are still complicated ;)

    Here is a link to how to set up the spreadsheet (you'll need a google/gmail account), and then follow the directions here:
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    And then this explains what each column is for:
    http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

    And if you're not tech savvy or if you run into any trouble, just post here and ask for help. We have a couple of folks who can help get it set up for you.

    If you can just input like the past week or two of data, we can start to take a look - you don't need to go all the way back to October (although if you're like most of us, watching the colors pop up is so much fun you might want to o_O) Okay, okay, I'm kind of a data nerd. Probably not that much fun...:p
     
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  3. AmFon

    AmFon Member

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    Feb 17, 2018
    My husband is also a data nerd...maybe I'll introduce him to the spreadsheet. :) Any idea of how often a day to feed? 3 times a day....every 3 hours, 4 hours, or just try and see? I've been to two different vets, both insist on twice a day, but it's not working. And poor Ringtail boy is hungry quite often.
     
  4. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    How is his weight? If you put out a can of food, does he inhale the whole thing? Has he ever been a grazer?

    I leave out canned or raw food all day and let my cats graze on it. If yours snarfs the whole thing at once though, we can talk about some tricks and timing. Also, are either of you home during the day? Or gone for work/other obligations?
     
  5. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Welcome! I have a link in my signature to the AAHA guidelines for diabetes management. They say that feeding four times a day is ideal, and if your cat is underweight, free-feeding is fine.
     
  6. Rachel

    Rachel Well-Known Member

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    Most folks here feed several small meals a day or free feed. It depends on what works best for you and your schedules/your cat. I do 2 meals a day, but my cat free feed on those meals...I just put out fresh meals morning and evening (we feed raw) and leave it out. They like being able to go back and forth and eat as they are hungry and they don't hoover it all up at once (though they did when we first switched to raw) so I have no qualms about letting them self-regulate how much/when they eat.
     
  7. AmFon

    AmFon Member

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    Ringtail definitely scarfs his down quickly. I also have two other cats who are grazers. (All three are indoor only.) My husband will put down some dry food for the grazers in the basement and close the stairwell door till they are done. I am a teacher, so I'm gone until about 4pm. My husband is always home.
     
  8. AmFon

    AmFon Member

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    Feb 17, 2018
    His weight is 15 lbs. This has been stable now for 4 months. Previously he weighed up to 21 lbs.
     
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  9. Djamila

    Djamila Well-Known Member

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    Hooray! Another teacher!!! There are a whole bunch of us on here!

    So if your husband is home, he can break the meals up into snacks. Is 15 pounds a good weight for him? Or does he need to gain or lose? If he needs to gain, start by adding an extra can of food. So start by feeding three cans/day instead of 2. Then break that total amount of food into probably five or six meals or so - breakfast, snack, snack, dinner, before bed snack. If either of you get up during the night, a middle of the night snack is great too. But if you don't naturally get up during the night, that usually gets missed because sleep is important.

    The easier option is a timed feeder. You can put five meals in it and just let it open at whatever times you program. Then your husband isn't chained to the house all day, and you can both sleep through the night!
     
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  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Welcome! I'm also a teacher (retired). Djamila gave you great advice. That spreadsheet will be very helpful to us. :D
     
  11. AmFon

    AmFon Member

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  12. AmFon

    AmFon Member

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    I think 15 pounds is a good weight for him, it would not hurt for him to lose another pound or so. My husband actually works from home and is up all night. I'm thinking feeding every six hours, a can in the morning and night, with a half-can in between. (Three cans total.) If that doesn't work I may break it into six.
    Yeah, it's a bit of a bummer having to get up at my usual time even on weekends, to feed the cat...I tell him he should really appreciate me. Ha ha.
    I suppose there are so many teachers on here because we like to learn, and are used to having to find out information for ourselves. I did put info on the spreadsheet, but lost it somewhere in cyberspace. I'll get hubby on it later to see if we can find and post it. Tech isn't my gift. lol
     
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  13. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Lol...I agree about having to wake up early on the weekends. Although to be fair, they usually woke me up too early anyway, even before Sam was diagnosed!

    I agree about what draws a lot of teachers here. That and we are all so well trained in looking at data these days! :rolleyes:

    I hope DH can help you find your spreadsheet.

    I was just looking over your numbers again, and I'm really concerned that he's getting too much insulin. In general we say that when a cat is newly diagnosed, not to give an injection if he's under 200. I think those super high 400-600 numbers are likely caused because he got an injection when he was too low and went hypo. A cat's body can usually handle a couple of those, but if it keeps happening, (and I don't mean to be alarmist here), but it can kill them.

    I would recommend getting a couple of tests during the day today, especially if you can get a test or two around four hours after the shot, and around six hours after the shot (although whenever you can would be helpful) and posting the numbers you're seeing. I would also strongly recommend lowering his evening dose by quite a bit - maybe down to 2u?
     
  14. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Former teacher here myself! We all congregate here I guess.

    I hated getting up early on the weekends when we first had this diagnosis. However, I now get up, feed, and then go back to bed (no diabetic). I usually get up at the normal time, feed them, hang around for a bit to ensure eating and not vomiting, then go back to sleep for a few hours. Not feasible for all I know since some folks can't go back to sleep after getting up, but it's a thought!

    I agree with Djamila after checking out your numbers. It looks like you're seeing some bouncing numbers after some very low number events. What do you think of her suggestion of lowering the dose?
     
  15. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    I agree with lowering the dose too. 2 units sounds like a good idea.
    I don't know how I survived without my auto feeder. Makes it so much easier to feed snacks.
     
  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree with the others about the dose possibly being too high. I like the idea of trying 2 units twice a day for a few days and getting a spreadsheet set up to track BG numbers. :)
     
  17. srk4cats

    srk4cats Well-Known Member

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    15 lbs. sounds like a good weight to me. My Chloe is less than 8 pounds.
     
  18. srk4cats

    srk4cats Well-Known Member

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    I'm a teacher, too, but I live alone and don't have anyone to help me. boo-hoo.
     
  19. StephG

    StephG Well-Known Member

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    There are a lot of members that are doing this all on their own.
    I'm lucky enough to have DH helping me and a woman I consider family helping when we both can't get home to test.
     
  20. Djamila

    Djamila Well-Known Member

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    I do it alone, and pay a pet sitter or vet tech to come over when I can’t be here.
     
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  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Me too - alone and with a disability that has destroyed my balance and robbed a lot of the strength from my hands. There are many people who struggle to do this.
     
  22. Rachel

    Rachel Well-Known Member

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    I did it alone as well.
     
  23. AmFon

    AmFon Member

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    I am home today; we are off for President's Day. Here are his weekend numbers: Sat. Feb. 17 AM 525 (injection 4.0) PM 370 (injection 3.5)
    Sun. Feb. 18 AM 159 No injection PM 565 (injection 3.5) Mon. Feb. 19 8:45 am 103 No injection 10:30am 473 (injection 3.0) I agree that I think he may be getting too much; I also wonder if it takes 14 hours to wear off instead of 12. So the number will look good at 12, but 2 hours later it's going up.
     
  24. AmFon

    AmFon Member

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    I am weaning him down slowly a half unit at a time.
     
  25. StephG

    StephG Well-Known Member

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    When the dose is too high it can last longer than 12 hours. Once you get to the right dose, you will start seeing the usual prozinc "smile" curve. Goes down in the middle and starts going back up toward the end of the cycle.
    You don't have to go down in dose slowly. But you can if that's what you want to do.
    2 units could end up being too much as well but the best way to find out is testing, of course you know this already.
    Once you start seeing two shootable preshot numbers, I would be very careful and monitor on that second preshot.
    Say you give 3 units on a 400 preshot and you get a 250 preshot the next cycle-- if you give 3 units again you'll want to test more often to make sure that's not too much. If the preshots are similar, it might not need as much monitoring but I would monitor in the beginning of the cycle just to make sure he's not going to throw a curve ball.
    That's why I was thinking 2 units would be a good place to start...
    Hope I didn't confuse anyone. Sometimes I type out my thoughts and it looks like a tangled piece of yarn!:joyful:
     
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  26. AmFon

    AmFon Member

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    Feb 17, 2018
    I followed you fine. Thanks for the info.
     
  27. Djamila

    Djamila Well-Known Member

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    Just wanted to check in and see how Ringtail is doing and if you've had any luck getting the spreadsheet going? Let us know if there is any way we can help. It'd be great to see him getting some consistently safe numbers. Ideally, you want to shoot both AM and PM doses as skipping here and there can make them feel a little icky. But it can be a little tricky to figure out what dose can be administered twice/day and keep Ringtail in safe, healthy numbers throughout.
     
  28. AmFon

    AmFon Member

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    Feb 17, 2018
    It's driving me crazy!! I'm home today due to winter weather. I just can't find any rhyme or reason to his numbers.
    Feb. 20 Feb. 21 6:45am 400 Shot 3.0 Feb. 22 6:30am 158
    7:30 am HI (600+) gave shot 2.5 6:15pm 95 8:30 am 504 Shot 3.0
    8:30 am 451 9:30 pm 545 Shot 3.0 12:30 pm 564 !!!!!!!
    6:15 pm HI Gave shot 3.0
    11:00 pm 351

    And that 564 is before food...I was going to give him his "snack"...do I ? Or not when it's that high? And usually I'm not home to check if it's high or not.
    Argh!!!!!!!!!!!!!!!
    I found the spread sheet, but saw that I need to enter the info. differently. I'll try to work on it this afternoon.
     
  29. AmFon

    AmFon Member

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    Feb 17, 2018
    Note: when posted, this squished my columns together. The info should be read vertically.
     
  30. Djamila

    Djamila Well-Known Member

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    That’s why we really wait for the spreadsheet. The colors and columns make it possible to see patterns that are very hard to discern from a list of numbers. I don’t mean to just keep harping on that, but it will make a ton of difference when we can see them clearly.
     
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  31. AmFon

    AmFon Member

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    Feb 17, 2018
    I understand! Hopefully time and improved skill will allow for it soon. (Plus hubby has been on this computer for skype meetings at work for the last three days...)
     
  32. AmFon

    AmFon Member

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  33. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hurray! Now - more homework for you: please set up your signature. That's the light grey text you see under our posts. Click on your name in the upper right of this page then click on "signature" in the menu that drops down. A text box will appear. Put in this information: kitty's name, age, date of diagnosis, insulin you use, glucose meter you use, what he eats, any other health issues/meds he has. Then, open your spreadsheet, copy the URL at the top of its page and paste it into the text box where you entered the other info. Save. We'll be able to see all of it including the link to your SS at a glance when you post.
     
  34. Rachel

    Rachel Well-Known Member

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    Great job! Putting it in your signature like Kris mentioned will help..then we can see it always. And now that it's all set up, you just have to enter numbers as you get them and they'll be laid out beautifully!

    Looking at it I'm definitely thinking your dose is too high. I'm glad you're bringing the dose down. His numbers are following the classic pattern of bouncing. He has a low number (blue or green) and then the next cycle or the next day he goes super high...and he stays high and flat for a bit. Then another low, another high and flat...etc.

    Have we gone over bouncing with you? I can't recall...here's something Kris wrote that explains it really well:

    Here's how it works:
    1. BG goes low OR lower than usual OR drops too quickly.
    2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
    4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing
    It's fairly common and considering you're getting those low numbers at preshot, it definitely shows the dose is too high. It will hopefully settle down some once you get him down to a better dose that doesn't cause him to go so low.
     
  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Another thing that's making his numbers erratic is the frequent doses changes and sometimes they change by a lot. I'd suggest choosing a moderate dose and giving it both AM and PM for several days. The goal is to get him more settled in his responses to ProZinc. It might be worth knocking the dose back to 2 u twice a day. That might be on the low side but it can be carefully increased in 0.25 u increments after a couple of days.
     
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  36. AmFon

    AmFon Member

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    I'm sorry, but how do I open the spreadsheet and copy the URL into the text box? I'm so tech dense. I got the signature to post.
     
  37. AmFon

    AmFon Member

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    Question: What do I do if his reading is below 200? Esp. if it's under 100...do I wait and give it later? Skip it entirely? I'm not usually home in the daytime to do that. I feed, give shot and go to work.
     
  38. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Great job on the spreadsheet and signature!!!! Here is a little video on how to link the spreadsheet:


    If he's under 100, you need to skip. Although lowering the dose will likely help with that issue. If he's under 200, you can stall for 20-30 minutes without feeding and test again. If the number is rising, and is getting into upper 100's you can shoot, if it isn't rising, then you need to stall again. Since you have to go to work and dont' have time to wait forever, is your hubby able to help with testing and shooting? Or is he needle/cat averse? ;) If he can help, great. If he can't, then you can shoot a reduced dose or skip. As you collect more data, you will learn what your kitty needs. Some kitties can take injections on lower numbers and be fine (like mine). Other kitties will go too low and need reduced doses. It takes some time and monitoring to figure out. We can help you sort that out as you go - just post when you get a PS number that isn't comfortable and we can help suggest what might work and keep him safe.

    I absolutely agree with Kris and Rachel about lowering the dose. Right now the dose is too high and it's causing him to bounce so much that you can't even tell what he needs. Drop back to 2u on the next cycle and let's see what he gets over the next few days. That should give an idea if he needs to go up or down from there.
     
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  39. AmFon

    AmFon Member

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    :bighug::cat: Thank you so much!!
     
  40. Rachel

    Rachel Well-Known Member

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    Can I ask what time do you usually shoot and what time zone are you in? It helps to us to know that so we can try to check in.
     
  41. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Next time you open your spreadsheet go to the top of its page and highlight/copy the web address from the bar at the top. Then come back to this page and click on your name and "signature". In the text box where you typed in the info we see now under your posts, paste the web address of your spreadsheet in there. Click save. We'll now be able to see it in your signature text. As it is now we have to go search for the link in your earlier posts.
     
  42. AmFon

    AmFon Member

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    I'm in the central time zone, just east of Omaha, NE. Usually shoot between 6:30 and 7:00 am and pm.
     
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  43. AmFon

    AmFon Member

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    Feb 17, 2018
    Okay, another question from not so tech-saavy me. How do I get my spreadsheet to allow me to update my information? I click on the boxes now, but nothing happens.
    Ringtail's reading yesterday (2/23/18) were as follows: 7am 110 7:40 136 8:20am gave his shot 2.0 units 7:15pm 600+
    Feb. 24 7:40am 477 gave shot 2.0units 3:30pm 133
    Except for the nasty 600+ reading last night, the numbers aren't too bad. He did surprise me by throwing up a few minutes ago. He doesn't usually do that, and I thought it was blood at first. On closer inspection, however, it looked more like the tuna he had for his snack a couple of hours ago. I caught him ingesting something (??) from the carpet about a half-hour earlier, so I suspect this may have been the cause. He will eat hair, dead bugs, anything sometimes. (Dumb cat...lol)
     
  44. Djamila

    Djamila Well-Known Member

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    Make sure you're signed into Google. It won't let you edit if you aren't signed in.

    Did you get a test around the time he threw up? Just curious if it would give any hints about why he isn't feeling well.
     
  45. Djamila

    Djamila Well-Known Member

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    If you open your spreadsheet and look in the top right corner, you should be able to sign in from there.
     
  46. AmFon

    AmFon Member

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    Feb 17, 2018
    No, no testing...seems fine now.
     
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  47. AmFon

    AmFon Member

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    Got it to update. Hooray.
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That green tonight is too low for insulin. I suggest you drop the dose to 1 u tomorrow AM.
     
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  49. AmFon

    AmFon Member

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    Feb 17, 2018
    Did not give him any. Just checked him again, it's up to 118. Still too low. Thing is, during the night it is likely to spike again, but I hate to keep sticking him all night.
     
  50. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Don’t worry about night time numbers tonight after no shot. I’d try 1 u tomorrow to see if you can get him levelled out.
     
  51. Djamila

    Djamila Well-Known Member

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    I agree with Kris. It looks like the 2u dose might still be too much for him right now. Dropping to one unit might not be enough, but right now we just need his numbers to stabilize instead of swinging from 67 to 600! Once he's a little steadier we can start to figure out what he really needs.
     
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  52. Djamila

    Djamila Well-Known Member

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    And as I've been thinking about this, I have a zillion more questions...:bookworm::smuggrin:

    Is he indoor only, or does he go outside? Are there any other pets in the house that eat different food?

    Also, have you been home testing ever since his diagnosis? I just re-read your intro and was wondering about his journey up to 4u and if he's ever had stable numbers? Did he swing up and down dramatically like this even in the earlier days of his diagnosis when he was on a lower dose?

    How did your vet decide on the increases? fructosamine test? in-office curve? at home curve?
     
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  53. AmFon

    AmFon Member

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    Feb 17, 2018
    Whew, I'll try to answer your questions. He is indoor only. The only time he goes outside is with me, on a leash. I have two other fur babies, a brother/sister duo named Rosie and Buddy. They eat with him in the mornings, and get their own snacks separately through the day.
    I took him to the vet for routine exam in August. He was very heavy (21 pounds!) and we put him on a diet to help him lose weight. Suddenly in October he started dropping weight way too fast, as well as peeing all the time, even missing the box a couple of times. I took him in and he was diagnosed with diabetes, and put on 1 unit of Prozinc twice a day. The vet told me to bring him back in two weeks to check it again. When I brought him back, at the nadir for testing, he was almost 600. (It must be noted that even the small dose did benefit him greatly...feeling better, weight loss stopped, more energy, etc.) I suggested home monitoring, the vet disagreed, saying it can be "inaccurate". Upped his dose to 2.5, said come back in two weeks. I did...it was still in the 500's. So he upped it to 3 units. At this point I decided to take him to a cat specialist in Omaha. She encouraged home testing and worked with me on getting some curves, staying in touch via e-mail. We discovered the swings with my home testing. It got upped to 3.5, then 4 units. She thought "perhaps" his pancreas was kicking in and out of working, but no real solutions. That's when I turned to this page. Any more questions? :cat:
     
  54. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think he’s spent the last 2 days bouncing from that green. I’d keep the 1.5 u dose for another day. Try to get a before bed test tonight.
     
  55. AmFon

    AmFon Member

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    Even though the readings of the last two days are higher than we would like, at least they are more consistent and are not up and down. Is this, perhaps, progress?
     
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  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, it is. :)
     
  57. Djamila

    Djamila Well-Known Member

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    Yes, it looks like he might be settling down higher than I was hoping, but at least he's settling down. How many hours between his PM dose and your bedtime? I'm wondering if you can get a +3 or +4 before bed without being exhausted for class the next day? If so, it would be great to get a peek at where he's heading with the 1.5u dose so we can have a game plan for the weekend. If that's too late for you though, no worries. Teaching is hard enough without adding sleep deprivation!
     
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  58. AmFon

    AmFon Member

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    Feb 17, 2018
    + 3 hours, and it is 354. Woo hoo!
     
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  59. Djamila

    Djamila Well-Known Member

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    Sleep well! Hope your kids are extra good for you tomorrow!
     
  60. AmFon

    AmFon Member

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    Okay, so now my next question. We appear to have thankfully reached a point of stasis; red for the last three days. But obviously these numbers are still to high. What can I do to try and get the numbers down, and what would be a good goal to aim towards number-wise? Thanks!:bookworm::cat:
     
  61. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Lots of guesswork involved because dosing is based on the pre shot BG as well as how low he’s going. I suggest you do a full curve tomorrow and we can take it from there. If you can’t get mid cycle data on work days you need to try hard to get at least a before bed test.
     
  62. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Goal: pre shots in the low to mid 200s and nadir in high double digits to low 100s.
     
  63. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    The next step is to start slowly increasing, but as Kris mentioned, we need a peek at a couple of mid-cycle numbers to know how much. Will you be home tomorrow? Could you grab a couple of tests in the +4 to +7 range? (or do a full curve if you'll be home through the cycle).

    There are two ways of thinking about that - one of is to do the curve first, and then check in before the PMPS tomorrow evening. The advantage of this is that if the mid-cycle numbers are over 200, you can change the dose more, and if they are under 200, you change the dose less. So knowing first can help make a better dosing choice. The other option is to make the dose change in the morning and then monitor through the whole cycle (so you'd need to be home through the day) in order to make sure he stays safe. Given how high and consistent your PS numbers are, I think either option is okay. The first option has some advantages, but delays the increase until Saturday night, and many people don't like increasing at night because you have to set an alarm to check on the impact. Or wait until Sunday morning and then you only get to see two cycles at the new dose before you go back to work. The second option lets you make the change sooner, but there is a little risk and the change wont' be as targeted.
     
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  64. AmFon

    AmFon Member

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    Feb 17, 2018
    I'll do a curve tomorrow and see what we get. I'll also get a before-bed reading tonight.
     
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  65. AmFon

    AmFon Member

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    Feb 17, 2018
    Did his curve today; still consistent in the 400's. We even went outside for a walk and had some exercise. I had hoped that might help bring the numbers down a bit...nah.
     
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Good info though. I suggest you go to 1.75 u tomorrow AM.
     
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  67. AmFon

    AmFon Member

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    Feb 17, 2018
    Seeing a little bit of a "swing" today with the change in dosage...a nice 293 this afternoon, and an obnoxious 569 at 9pm.
     
  68. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Oh, that is not pretty. I'd hold the dose tomorrow morning, and then if you can get a before bed test (+3 or +4), increase to 2u tomorrow night.
     
  69. AmFon

    AmFon Member

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    Feb 17, 2018
    So why do I withold the dose in the morning, as his sugar is high? And why would I increase to 2u tomorrow evening? Just wanting to know the whys.
     
  70. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Sorry hold the dose, not withhold the dose. I'm so glad you asked for clarification! I meant that I think you should keep the dose the same in the morning.

    The reason to keep it the same is that you aren't home during the day to test and it's best to only change doses when you can monitor to make sure if the kitty has a strong initial reaction you can keep him from going hypo.

    The reason for increasing tomorrow night is that the mid-cycle number today is too high still, and the big increase at +2 tonight both indicate that the dose is too low.

    We had you lower the dose just to stabilize the bouncing, but now we need to start increasing again to get into some better numbers. The hope is that the small steady increases will get you into better ranges without setting off those wild swings you were seeing before. If Ringtail starts swinging from blacks to greens to pinks to blues again, then we'll need to slow down the increases, but I'm hoping that every three to four cycles will be okay.

    And always always ask when we say something that doesn't make sense! You never need to feel badly about asking for more information!
     
  71. AmFon

    AmFon Member

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    Feb 17, 2018
    THAT does make more sense...it's late, so, yeah...so I will keep it at 1.75 tomorrow morning, then increase to 2.0 tomorrow night, and monitor closely.
     
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  72. AmFon

    AmFon Member

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    Feb 17, 2018
    First day with 2.0...not too bad, I guess. No spikes, and a reading in the 300's this evening. I'll take another reading around 10pm.
     
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  73. AmFon

    AmFon Member

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    Feb 17, 2018
    10pm reading 308...:)
     
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  74. AmFon

    AmFon Member

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    Feb 17, 2018
    Not amused at an AM reading of 600+ this morning...I thought things were mellowing out into the 300's. This is so frustrating!
     
  75. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    That is really surprising. Thank goodness the weekend is almost here and you can get some mid-cycles to see what's going on with this dose. It seems unlikely that he went too low overnight, but anything is possible with these kitties!
     
  76. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    One thing when you get a number that's really surprising like that is to do a second test. I got a HI the other day and nearly had a heart attack. When I retested it was 121. Sometimes there's a bad test strip, or having too much or too little blood on it can make a false reading as well.
     
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  77. AmFon

    AmFon Member

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    Feb 17, 2018
    Sugar still too high...increased a little more, up to 2.5 tonight.
     
  78. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Good. Just keep up those steady increases and you’ll get there. Yes, his numbers are still high but he’s much more settled and you haven’t had to skip doses because of a low PS.
     
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  79. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    I know it sucks, but his SS actually is way better than before when you had lows and then soared back up. It's steady and you'll DEFINITELY get him there with those increases. We know he CAN go down with the insulin, we just have to help him figure out what's a good dose.
     
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  80. AmFon

    AmFon Member

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    Feb 17, 2018
    Okay, I have Ringtail's latest numbers. It actually looks like his numbers looked better at 2.5 than they do with a higher dose...what's up with that?
     
  81. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You're still trying to get to a good dose range. I'd stick with the 3 cycles then increase by 0.25 u for now. You have a bouncy cat and that makes all this harder. Have you been testing his urine for ketones?
     
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  82. AmFon

    AmFon Member

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    Feb 17, 2018
    No, I have not. How do I test for ketones? This morning's reading was 540; he was in the 500's all day yesterday.
     
  83. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
  84. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Ketone testing is super important...and it really isn't as hard as it sounds. There's lots of tips and tricks to help. :)
     
  85. AmFon

    AmFon Member

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    Feb 17, 2018
    Forgot to mention-on the day you see the recent 600+ reading in the evening, he had a rabies shot about 4pm. Could that have elevated his readings?
     
  86. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    I dont' know about the rabies shot itself, but going to the vet can definitely raise their BG!
     
  87. AmFon

    AmFon Member

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    Feb 17, 2018
    High readings all day today...not a happy camper.
     
  88. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Go to 3.25 u and keep it no longer than 3-4 cycles. If no improvement go to 3.5 u for 3-4 cycles. Don’t hold an ineffective dose any longer than that because glucose toxicity can take hold. When yellows and blues appear regularly you can slow the rate of dose increase.
     
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  89. AmFon

    AmFon Member

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    Feb 17, 2018
    Here are Ringtail's latest numbers. Had to drop back to 3.25 for a bit because I could see a "swing" developing ( 60 at night, over 600 the next day). Had to see the vet to get insulin. She wanted me to jump him back up to 4.0 right away...um, that's how he got such bad swings to begin with!? She doesn't seem to understand the incremental increases. Neither did the last vet...should I look for yet another? I have to have a vet to get the insulin.
     
  90. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You did the right thing in dropping back to 3.25 u regardless of what your vet said. You have a very bouncy cat who might do better on a depot insulin like Lantus. You might want to ask your vet about that. If you like this vet for other pet care no reason to switch. Most don’t know about or recommend what we do here - tiny increases, etc.
     
  91. AmFon

    AmFon Member

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    Feb 17, 2018
    Have updated Ringtail's numbers for April.
     
  92. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Today's numbers are great! Hang in there. :D
     
  93. AmFon

    AmFon Member

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    Feb 17, 2018
    Yeah, they WERE great...then checked him two hours later (couldn't give him a shot, of course, with BG of 189...) and his BG was HI, over 600. Gave him a shot at 3.75 again. Grrr...
     
  94. AmFon

    AmFon Member

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    Feb 17, 2018
     
  95. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Wait, so you gave him his shot two hours late? On your spreadsheet it looks like it was on time. If it was late, can you shift the numbers over so someone looking can know you shot late? (if I understood that correctly).
     
  96. AmFon

    AmFon Member

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    Feb 17, 2018
    Yeah, I gave the shot two hours late, since I could not give it with that low number.
     

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