Smiffy's pancreas may be working again a bit - help!

[Looby & Smiffy]

@Elizabeth and Bertie @Tuxedo Mom @Diana&Tom

I really hope the three of you can help me with Smiffy - I think she is entering a new phase of her recovery and I would really like your advice and to be able to contact you during the day for Smiffy's sake. The three of you have known Smiffy from the outset so your opinion is all the more valuable to us

I sent you all a message about a week ago that I hope you have been able to read.

For the past couple of days there has been a new trend in Smiffy's numbers and it is making me think that maybe her pancreas is starting to produce a bit of insluin again - what I think you would call 'spluttering'?

Yesterday for the second day in a row her numbers went down after her AMPS, then up again as you would expect, but then down again after she had had a small snack so that her PMPS was low - low enough for me not to give her a shot:

AMPS: 16.8
+3 6.4
+4 8.1 wet food snack and a few biscuits betwen +5 and +7
+8 12.4
PMPS 9.5

I have recently bought some Thrive and Porta21 Sensible dry food that I am mixing with her Hills m/d and also she has a little wet snack in the afternoon at about +5/6 (she is gradually eating more of the wet food but not enough yet to constitute a main meal yet) but overall her carbs are a bit reduced.

I am thinking that these numbers would suggest that after she had her snack which contributed to her numbers going up, her pancreas kicked in a bit to lower the numbers again? What do you think? Usually once her numbers start to rise they continue to do so until her PMPS. I keep her spreadsheet up to date.

I only have to give Smiffy one unit in the morning to get her numbers down into the blues now and for the past couple of nights she has been below 10 preshot so I haven't had to give her any insulin.

I am guessing that her high AMPS reading is high because she has bounced? How long do you think she will continue to bounce for her AMPS?

Do you think it is worth me giving her a half unit in the evening if she is at the top of her blue number range ie 11.1 to try to get the AMPS down or should I just wait for her to stop bouncing?

I really feel that Smiffy and I need your support and advice now that things are changing for the better - it is great but it is a bit scary too ....

Hope you are all well and that Smiffy and I will hear from you

Looby and Smiffy

 

[Looby & Smiffy]

Smiffy has 'surfed' on blues today and once more is not high enough to give her a shot - just on the cusp with a pre-shot of 10. At =7 she was 10.3 so either the Caninsulin is lasting the full 12 hours or her pancreas is helping out a bit.

If she had eaten tonight I might have been tempted to give her 0.5 shot but as it is hot and she is not hungry I am not going to risk it.

 

[Olive & Paula]

Wish I could provide some insight for you. But she is looking good.

 

[Marlena]

Looby, Smiffy is doing great, well done.
If you feel confident and you can monitor it might be a good idea to give Smiffy reduced dose of 0.5 units on a blue number like yesterday PM (10).
She did not drop too low at her nadir yesterday (7) so you could try that as you're now so experienced and you are pretty confident in you ability.
I can't tell how wonderful it is when we consider your difficulties at the beginning.

We are doing great, Rocky's been to the vet's for testing (suspected UTI) and today is his last day od OTJ trial. I hope I'll be able to send you and Smiffy an invitation to his OTJ party!
Take care, lots of hugs to you, Smiffy and Pasha from
Marlena and Rocky

 

[Looby & Smiffy]

Looby, Smiffy is doing great, well done.
If you feel confident and you can monitor it might be a good idea to give Smiffy reduced dose of 0.5 units on a blue number like yesterday PM (10).
She did not drop too low at her nadir yesterday (7) so you could try that as you're now so experienced and you are pretty confident in you ability.
I can't tell how wonderful it is when we consider your difficulties at the beginning.

We are doing great, Rocky's been to the vet's for testing (suspected UTI) and today is his last day od OTJ trial. I hope I'll be able to send you and Smiffy an invitation to his OTJ party!
Take care, lots of hugs to you, Smiffy and Pasha from
Marlena and Rocky

Lovely to hear from you Marelena

I am so pleased to hear that Rocky is nearly OTJ!!! But hope the UTI proves to be negative - must be painful for a puss cat.

Thank you for your continued support for Smiffy.

I think you are right about the dose in the evening. Provided her preshot number is around 10 (not too low) and that she eats a good amount it would be worth me giving her a 0.5 unit shot to see if I can bring that AMPS down a bit. I am reluctant to do it the other way round ie give her 1.5 units in the morning because I am not around for her Nadir as you know.

What do you think about her going down in her cycle, then up and then down again? That is the thing that is making me think that her pancreas may be spluttering?

Hugs back

Looby & Smiffy

PS does Smiffy's spreadsheet resemble in any way how Rocky started to go into remission? I must have a look

Oh my goodness just looked at your spreadsheet and you have to be brave with the dosing don't you .... and you did lots of tests every day .... I also noticed that towards the end you were giving him 'drops' of insulin and not even a half unit ...... will I ever get Smiffy over the juice if only use the pen and have increments of half unit to play with ..... really not sure about using syringes!

 

[Marlena]

Thank you for your continued support for Smiffy

What do you think about her going down in her cycle, then up and then down again? That is the thing that is making me think that her pancreas may be spluttering?

You're very welcome.
Yes, you are right, it might be that or she has another drop because insulin like Caninsulin can do that.
Unfortunately you can't see how I was dosing Rocky when he was on Caninsulin but I put him in remission by using 0.5 u (in a pen) on preshot numbers as low as 4.5 on human meter for a week before I stopped giving any insulin.

His recent bout of FD was a very bumpy road for us and I have been doing it with Hypurin for 8 months now and I have to admit that sometimes I did not know what I was doing and other times I thought "ok, I have to be brave and push him harder" and I knew I was there for him to bring his BG up if he was too low. You just need to consider everything: are they eating, am I able to watch like a hawk and act quickly if I need to, do I have nerves of steel to cope when problem occur?
You might just be able to get Smiffy into remission with half unit doses but don't totally reject the idea of syringes, you can do it if you put your mind to it, just think how fantastically well you coped with everything which looked so difficult at the beginning!
Just looked at Smiffy's SS - Looby, it looks really good.
Can you post her PMPS - I'll try to see it as soon as you post so maybe we can decide together what to give her tonight. What time do you test?
I will test Rocky at 7.30 tonight and if the BG is good we are going to have a partyyyyyyy!

 

[Looby & Smiffy]

You're very welcome.
Yes, you are right, it might be that or she has another drop because insulin like Caninsulin can do that.
Unfortunately you can't see how I was dosing Rocky when he was on Caninsulin but I put him in remission by using 0.5 u (in a pen) on preshot numbers as low as 4.5 on human meter for a week before I stopped giving any insulin.

His recent bout of FD was a very bumpy road for us and I have been doing it with Hypurin for 8 months now and I have to admit that sometimes I did not know what I was doing and other times I thought "ok, I have to be brave and push him harder" and I knew I was there for him to bring his BG up if he was too low. You just need to consider everything: are they eating, am I able to watch like a hawk and act quickly if I need to, do I have nerves of steel to cope when problem occur?
You might just be able to get Smiffy into remission with half unit doses but don't totally reject the idea of syringes, you can do it if you put your mind to it, just think how fantastically well you coped with everything which looked so difficult at the beginning!
Just looked at Smiffy's SS - Looby, it looks really good.
Can you post her PMPS - I'll try to see it as soon as you post so maybe we can decide together what to give her tonight. What time do you test?
I will test Rocky at 7.30 tonight and if the BG is good we are going to have a partyyyyyyy!

Thank you Marlena and that is very reassuring to know that I could achieve remission for Smiffy with the pen alone - I hope so! I have got the syringes here ready but I don't want to use them unless absolutely necessary.

I will be testing Smiffy tonight between 9.30 and 10.00pm so quite late! Are you about then?

Would it be easier for me to let you know her PMPS here (where there seems to be a delay for me) or by Skype?

 

[Marlena]

Thank you Marlena and that is very reassuring to know that I could achieve remission for Smiffy with the pen alone - I hope so! I have got the syringes here ready but I don't want to use them unless absolutely necessary.

I will be testing Smiffy tonight between 9.30 and 10.00pm so quite late! Are you about then?

Would it be easier for me to let you know her PMPS here (where there seems to be a delay for me) or by Skype?

You could Skype me, I'll try to be around. I did not sleep well last night and might be too tired at 10 but I might be all right, I'll let you know.

 

[Capoo]

Hi Looby,

Just a short message to tell you that with Caninsulin, the time of the Nadir is dose dependent:
For a big dose, the nadir will occur later than with a shorter dose.
With 1,5 IU, the Nadir of Smiffy occurs at around +5, but with a smaller dose, it will occur sooner. For example, on August 22nd, you injected only 1IU, and the Nadir occurred at around +3.

Sophie

 

[Looby & Smiffy]

Hi Looby,

Just a short message to tell you that with Caninsulin, the time of the Nadir is dose dependent:
For a big dose, the nadir will occur later than with a shorter dose.
With 1,5 IU, the Nadir of Smiffy occurs at around +5, but with a smaller dose, it will occur sooner. For example, on August 22nd, you injected only 1IU, and the Nadir occurred at around +3.

Sophie

Thank you Sophie

That is the first time I have heard that!

So what you are saying is that I could risk giving her 1.5 units in the morning as I would catch her Nadir at around +5?

xxx

 

[Capoo]

Thank you Sophie

That is the first time I have heard that!

So what you are saying is that I could risk giving her 1.5 units in the morning as I would catch her Nadir at around +5?

xxx

With Caninsulin, my cat had his nadir at around +8-9 with terrible high doses (>6 IU), but the nadir was very very low (sometimes less than 40 with a pet meter...)
But with smaller doses, lets say less than 4IU, his nadir occurred between +2 and +3, but was higher in terms of BG.

My vet and an endocrinology professor confirm this dependence between doses and nadir times with Caninsulin.

Regarding your question, it really depends on her AMPS.
With a higher dose, the nadir will occur later, but it will be lower in terms of BG.

I hope that I'm clear, have some doubts...

 

[Looby & Smiffy]

Hi Looby,

Just a short message to tell you that with Caninsulin, the time of the Nadir is dose dependent:
For a big dose, the nadir will occur later than with a shorter dose.
With 1,5 IU, the Nadir of Smiffy occurs at around +5, but with a smaller dose, it will occur sooner. For example, on August 22nd, you injected only 1IU, and the Nadir occurred at around +3.

Sophie

But then on the 18th I gave her 0.5 units (because she didn't eat a lot) and her Nadir was around +4 or earlier?

 

[Looby & Smiffy]

With Caninsulin, my cat had his nadir at around +8-9 with terrible high doses (>6 IU), but the nadir was very very low (sometimes less than 40 with a pet meter...)
But with smaller doses, lets say less than 4IU, his nadir occurred between +2 and +3, but was higher in terms of BG.

My vet and an endocrinology professor confirm this dependence between doses and nadir times with Caninsulin.

Regarding your question, it really depends on her AMPS.
With a higher dose, the nadir will occur later, but it will be lower in terms of BG.

I hope that I'm clear, have some doubts...

Understand

 

[Capoo]

But then on the 18th I gave her 0.5 units (because she didn't eat a lot) and her Nadir was around +4 or earlier?

It could have occurred earlier in fact.

 

[Jill & Alex (GA)]

I will be testing Smiffy tonight between 9.30 and 10.00pm so quite late! Are you about then?

Would it be easier for me to let you know her PMPS here (where there seems to be a delay for me) or by Skype?

You could Skype me, I'll try to be around. I did not sleep well last night and might be too tired at 10 but I might be all right, I'll let you know.

@Looby & Smiify @Marlena
This thread has been brought to the attention of the moderators.

Just a friendly reminder...
In the true spirit of the FDMB, dosing advice should be posted publicly on the FDMB where suggestions and discussion are available for peer review. This is for everyone's benefit since we are laypersons, not veterinarians.
Thank you!

 

[Looby & Smiffy]

@Looby & Smiify @Marlena
This thread has been brought to the attention of the moderators.

Just a friendly reminder...
In the true spirit of the FDMB, dosing advice should be posted publicly on the FDMB where suggestions and discussion are available for peer review. This is for everyone's benefit since we are laypersons, not veterinarians.
Thank you!

I was just about to do that and post the data here!

It was just circumstances that led @Marlena and I to Skype so that she could alert me to when she was ready for me when I was testing as Marlena was going to bed early tonight and by Skype it was easier for her and gives us both a audible alert .... she Skyped me just before she was about to go to bed ....

I had every intention of posting the data for Smiffy's sake as well as the benefit for anybody else reading this thread

By the way there was no mention of Marlena giving me dosing advice by Skype - I was simply going to give her Smiffy's PMPS.

As I say and if you look back at my other posts here and on other threads, I always post dosing information or ask for dosing advice her on the FDMB openly and clearly ....

I feel as if I have been a bit unfairly treated here and it is not fair on Smiffy .... this is all about her care and we are approaching a difficult time where her numbers are decreasing so I could do with as much support as possible for her ..

 

[Looby & Smiffy]

@Marlena @Capoo @MrWorfMen's Mom So Smiffy has a higher PMPS tonight and she ate a bit of food after we spoke Marlena so I have given her one unit in the hope that her AMPS will be a bit lower tomorrow morning than it has been for the last few days

Thanks Marlena

 

[Jill & Alex (GA)]

@Looby & Smiify

Allow me to clarify:
Offering dosing advice off board is frowned upon because we are a peer reviewed message board, as you're well aware. Keeping everything on the board is a time honored tradition and a beneficial system for each and every member as well as all the cats.

Lucille, I'm going to be very candid. You've managed to dance around the subject of using Skype with Marlena for dosing advice. "If" you only relayed Smiffy's blood glucose number, what did you thank her for? Listening to you recite Smiffy's PMPS number? Those are rhetorical questions. No response necessary. If one reads through the previous posts it doesn't take an Einstein to put the pieces together.

I feel as if I have been a bit unfairly treated here and it is not fair on Smiffy .... this is all about her care and we are approaching a difficult time where her numbers are decreasing so I could do with as much support as possible for her ..

YOU have been unfairly treated? You?

Allow me to comment from MY perspective...
You've pushed the envelope over and over again. You've managed to alienate at least 4 members (that I know of) to the point where they want nothing to do with you here nor on Facebook and refuse to respond no matter how many times you continue to "tag" them in your posts or send them private messages. I have personally spent more time dealing with your posts that have been reported than on anyone else in my entire 10+ years on the FDMB. Please don't talk about being treated unfairly! Trust me, you've been given more consideration than you could possibly know.

I'm closing this thread because there's no point in continuing this banter and I'm becoming short on patience. Please start a fresh thread in the morning... or don't. It's up to you.

 

[Robert and Echo]

I echo Jill on this. Jill is explaining that the spirit of this place peer review because we're not vets, nor should anyone purport to be the expert less they are licensed. There is a significant liability involved in dosing advice. Explaining the spirit of the board isn't 'treating someone or someone's cat' unfairly. It's explaining the spirit. Thanks for closing the thread Jill, and thanks for everyone's dedication to the fur friends.