Snowflake, day 2 after double dose mistake

continued from http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=68876

Well, after giving slightly less than 0.3 units at 330 +13, she is now at 420 at +3. Not exactly sure what to do about this. Is it ever okay to give a tiny bit more? like, maybe just barely 0.1 unit?

Oh! and I forgot to post my name:

-Kathryn, with snowflake and midnight

 

Hi Kathryn,

Generally speaking, no, you shouldn't add more to the first dose, even if it looks like it wasn't enough. One reason is that sometimes it is just a matter of a cycle not running "normal". Sometimes they run long, and the onset, nadir and duration are all later than normal. If you add to it, the timing gets further messed up, and doses can overlap. Better off just riding it out.

Welcome to pzi!
Carl

 

true, I do NOT want a repeat of the last two nights, guess it's better to be a little too high--she just hasn't been this high in weeks, so the numbers are scary to me.

at almost +3.5 she's back down to 378, so at least it's moving in the right direction! I"m curious to see with the lower dose if her pancreas starts to kick in...

 

What is Snowflakes diet like? Curt (my diabetic kitty) had numbers ALL over the place before he went into remission. He was also on PZI, but was getting one whole unit because his numbers were so high (400+) at dx. In the end it turned out his dental condition was a major factory, but it was also his diet! I heard a lot of people on here recommend a diet of 100% wet lo carb, but his vet kept trying to give me dry prescription crap. I was also worried about hypos so i gave him a lot of dry food still, and treats every time id give him a shot. We never got a number under 200. One day I took the advice of the wonderful people on here (Thanks Jenn and Baxter! and started the wet lo carb all the time and his numbers went into the lo 100s almost immediately. To prove it was the food causing his high numbers, one day I came home from work and found out he jumped on the table and chewed into the dry bag and was munching all day long.. he was back to 400+ that evening!! And that morning he was just fine. So finally I just got it completely out of the house and we never had another high number again. A few weeks after that he went into remission. I think his pancreas still had some life, but the diet was too much for it, the insulin gave it a jump start and staying permanently on the wet helped keep it working well. I hope Snowflake kitty gets better regulated soon! Paws crossed! bcatrun_gif


Tom and Curt

 

Welcome to PZI!
I am sorry you had a rough start
but you will get used to the dosing
Looking forward to getting to know you both!

 

HI Kathryn,

It looks like the relion ss is most up to date, can you input some data in there for the last couple days. I know you had some crazy testing in there, just choose a test out of the cluster for each hour if it's easier and you are time crunched. So much happened it's hard to read through the posts and figure it out. It looks like you were in a good place before all this happened, hope those numbers will come back down for you soon!


Very suspicious as well that you were seeing Mr. P, if those low blue pre shots come back do a food test. You feed a small meal, no shot, wait 45min-1hr, and test to see if BG holds or comes down on it's own. Then you keep testing, giving more food every few hours especially if you see numbers climbing. For some reason, food triggers the P to produce more insulin so feeding a rising number tends to take it back down. I think if you'd tried it last week you would have been in a OTJ trial right now, but I think snowflake will get there again.

Of greater concern to me: Some of your PS are too low to have had insulin shot into. Most people who are new have a no shot below 200 rule, but snowflake is already doing what we call shoot as needed, shots are not on 12 hour schedule because he doesn't always need insulin. This still has a no shot rule, but it would be 150ish. You should never shoot a 116. You should do the food test, and wait and see if his numbers fall on their own.

Amazing that he was not even diagnosed 2 months ago, this looks very promising.

Cathy

 

If you are going to shoot low numbers, there isn't really a line in the sand other than the one you draw yourself. You need a good bit of data, you need a great deal of self-confidence, and you absolutely need to be watching afterwards.
116 is low. But I shot into a green number once or twice. Not saying you should do that! As long as you realize the risk, you can shoot tiny doses into low numbers.
Carl

 

Strike my previous thoughts, as Carl said it's all what you are comfortable with. However, I would be careful in the future with 0.4u into a 116, there wasn't another test until +7. Everything turned out fine, but just be careful next time.

 

I am feeding all lo carb wet (EVO duck is their favorite!) but I do keep what is left of the dry food I had before in the house, because her civvie sister is a very picky eater and has always been on the thin side, so I'll give her a handful (maybe 10 pieces of kibble--it's nature's balance duck and pea) in the mornings while standing over her. I only gave it to snowflake because of the oops double dose I did, as I didn't have any high carb wet food in the house, and I couldn't have stayed up through the night shoving honey into her mouth every hours--I would've gone crazy and i'm sure she would have hated me by morning. Must leave for work soon but I'll update the ss probably on Friday when i'll have a little extra time. Yesterday morning AMPS was around 450, this morning it was 370, so it looks like her body might be coming back down closer to its norm.

Thanks for the warm welcome!

-Kathryn

 

Also, I think I'll continue to shoot into lower numbers, but at a reduced dose--maybe just 0.2 if under 150. I like the idea of TR, I just don't have a schedule that allows very close monitoring. Ideally, I'd like her to be below 100 all the time. Every time I've tester her civvie biological sister, she's been between 50 and 60, so I think naturally that should probably be where she should be.

 

I think you are very on top of things, so I have no doubt you can handle shooting into low numbers. The thing is that your ss looks like a cat going into remission, so if you just continue shooting those low numbers without the food test, you don't know whether she needs the insulin or not. It could very well be that she is able to control her BG on her own. I know you doubt it right now because of your high numbers after that double up, but with a damaged P the P doesn't seem to kick in until BG is below 200. I have a feeling that once she's down in those numbers again that if you try holding the shot and feeding that you're going to see she drops on her own, maybe not every time at first and when she doesn't drop then you give her the insulin. TR is a beautiful thing for long term diabetics, I just think that your cat is not going to be on insulin very much longer. Your SS looks like she's on one of the L insulins, with the way Prozinc works there is no way you could keep a cat below 100 all the time, TR on an L can but not a PZI. An ideal curve on Prozinc would have a high blue to 200 PS and 80-100 nadir, you've achieved well below that already. I think Mr. P has been playing.

 

That is really encouraging to hear. I would be beyond happy to get her into remission! Let's see how she does in the next few days. I'm hesitant/anxious about how to handle things while I'm out of town (leaving next thursday night and will be gone for 9 days), as this is the first time I've ever used a pet sitter, and I will be out of the country in a totally different time zone. Should I hold off on doing a trial w/o insulin until I'm home, or start it and just stay in close email communication with the pet sitter--assuming she comes back into normal range before I leave?

 

I would say lets go day to day right now and see what happens. If she gets down again and we can test to see if she's producing insulin then having her continue as needed is fine, but because you have a sitter coming only once a day she most likely will need a set of guidelines on what to shoot because she will most likely catch her after she's risen more than you would have let her. Cats never do this kind of thing when it fits into your schedule, of course.

Here are a couple SS to see what the as needed looks like, for a cat to be OTJ they have to stay at 150 or lower and be mostly in the green for 14 days after the last shot. Anything 150 or below is great, and we don't shoot at it because the P needs to figure out how to do this on it's own. As needed means trying to catch numbers above 150 and correct them with insulin when you see them, there is no more 12/12 schedule and as long as there has been at least 8 hours (some are more comfortable with 10 or 12 hours still) and the cat is above 150, you give the shot. You end up skipping doses and seeing longer and longer cycles, and typically the greens don't come until the cat has been missing shots and the P brings them down all on it's own. So if you can go NS and she just stays in the 130's she will eventually come down on her own. Chewy, kse's kitty, came all the way down from 150 on his own and is now staying in the greens.

https://docs.google.com/spreadsheet/ccc ... zSnc#gid=0

This is still going on, if someone would UPDATE their SS! Josie is currently on day 11 of her OTJ trial. Convinced her to try the food test rather than shoot, and it worked.
https://docs.google.com/spreadsheet/pub ... utput=html

And you can check out my Kitten's ss as well, we went really fast though.

The most important thing is, these kitties are all in remission...you don't see ss like what you have the last week (before the accident) normally ::antijinx::

If she's still high at PMPS I would shoot your heavy dose, think you go up to 0.5u sometimes?

 

yes, I was at 0.6 for a long while, then at 0.5, then knocked it down to 0.4 after the double dose incident. This morning I shot 0.4 at around 370. I'm going to go home and check it at +6, which is in about 3 hours, and will report back then. Unfortunately I can't update my ss when I'm at work, as all cloud computing is blocked and google docs are on the cloud.

 

Shoot, I think a post I wrote may not have been submitted. Also wanted to say that I'm going to be taking tomorrow off to relax and study before taking the GMAT on Saturday, so I plan on doing +3 tests all day tomorrow, and will report those back here.

 

Well, I hope her PMPS is down for you...it does stink the double dose happened, but if it hadn't no one would have seen your ss so hopefully she'll get back on track and we can get her off the juice.

Good luck with the GMAT,don't envy you on that. Check out those links to other ss above when you get a free moment.

 

Thanks! This really did happen at just the worst possible time for me--right before I take the GMAT (ergo, taking over two night of valuable studying time) and a week before an international trip. but c'est la vie. Maybe if I had been more active on here from the get go we would've been in an otj trial by then. Oh well. all I can do is move forward.

 

It always happens at the worst time! I wouldn't kill yourself with testing if she's still high, just wait for the next low ps and then you'll need to get the tests in again....get your rest while you can girl!

 

woo hoo! 188 at +8--much closer to her normal. So, PS was 372 and here we are. I'm curious to see where we'll be at +12.

 

WOO HOO!!! If she comes down some more lets try the food test and get this rolling, so your shot time would be around midnight est? I'll stay up!

Get it Snowflake!

 

I feel like doing a little dance! 163 at +10! Thanks for offering to stay up! So the basic premiss is, see where she is at +12, then feed, wait an hour and see what happens? Should I take away her access to food now?

 

Sure, pick up the food for now. Essentially you're already doing a food test! Prozinc typically wears off and most cats are on their way back up by +8. A falling number at +10 is already a good sign because it is not likely that the insulin is causing that drop, of course the last two tests are basically the same because of meter variance, which is 20%. Either way if the number is holding or falling, that's great. Another test that is lower would be enough to confirm a drop, and I would think you would be able to continue on like this for awhile tonight. Many people still don't shoot below 180, I didn't shoot below 200 myself, so you could raise your no shoot number temporarily and see how she does. Hope the +12 continues to show downward movement so we can get this party started!

My last few cycles I fed at +10 if she was mid 100's to see the response, she'd either rise and become shootable or drop again and go NS...useful if you need to stay on a 12/12 or don't want to be up all night trying to catch a rising number high enough to shoot.

 

Glad you updated your ss, I see something else promising.... 4/17 pm she was 196 and she got 0.4, if that next test is truly a +2 that 77 is good because typically Prozinc would onset around +2. That kind of drop at +2 would suggest that Snowflake has a functioning pancreas, that drop is unlikely to be just the insulin.

I do think you should reduce if she needs shots in the future, I am completely comfortable seeing 30, 40, 50...just not on .4u or .5u. I would try .2 if you have to shoot below 200 again. A 40 on .2u or less is a lot less worrysome than when it's closer to .5u.

 

That was definitely actually at +2, maybe even something like +1.75, however, she's a very petit cat, so might a small dose kick in faster when her body volume is so much less than many other diabetic cats?

just tested and at +11, she was at 201, which I thought looked odd, since she hasn't eaten, so I tested her again, less than a minute later and it said 186 (tested using freestyle too, and it said 170). I don't want to waste test strips chasing a number, so could this just be within standard error?

 

Yes, all three of those numbers are within the margin of error, so still looking great!

Well then, that calls for this:


Carl

 

201 could be 160-240 (20% error), 186 could be 150-222, 170 on a different meter no less could be 136-204... so yes, don't waste your test strips. If you got a really wonky reading, like 100 or 270 then I'd test again, but if you're within that variance I'd take it as it is. If she stays at 200 I would forgo the food test tonight, her pancreas did a lot today and may be tired. I would try a .2 or maybe .3 tonight depending on her ps, and see where that leaves her in the morning, then we'll go from there. She did a lot today, don't get discouraged!

 

haha maybe I'll have to save that one for when we successfully declare otj!

 

I don't know, that guy creeps me out a bit....

 

Cathy,
Less creepy, or more creepy?

 

Less creepy....i think it's the big cheesy yellow head on a humanoid body that does it....I'll probably be seeing him in my sleep!

 

LOL, sorry! Didn't mean to cause anyone nightmares...

Carl

 

Holy crap, I just snorted a granola bar out my nose! LOL

 

okay, 172 at +12. It's only 8:45pm here, so I can feed and test again in an hour? or I can shoot 0.2? thoughts?

 

You can do either, how much is it going to screw up your schedule to wait if you feed and test in an hour? Typically most don't shoot under 200 unless the number is confirmed to be rising beyond meter variance, an you have been flat for the last 4 hours considering variance, right?

 

I would probably go with shoot the .2 now, and try to catch the rise before it kicks in?


Carl

 

Oh, my answer assumes that it is her dinnertime... and that she cleans her plate.
Carl

 

I'm a little nervous about shooting now, since she was at 196 on 4/17 and when I shot 0.4 it sent her into a total tailspin. I think I'll wait another hour and see how she's doing.

 

I'm with you on that. You hold the needle, and you've had a couple of late night parties this week already!
Carl

 

She is dozing and seems to not care at all that food is out. They've both been grazers their whole lives so they never get all that excited about food (part of why they are at such healthy weights--they only eat when hungry and not until full--wish I could do that!).

 

I definitely wouldn't shoot that high a dose again! I think you're good either way, just know that if she holds after food you're gonna have to keep on her and catch her if/when she does rise.

 

If she is napping, and not eating, it might be worthwhile just to see how she does without insulin. Her number shouldn't rise without food in the picture unless her pancreas just takes the rest of the night off. In which case you'd see a rise without food.

Carl

 

Try to get her up and eating a little....I find poking works well. Cats hate to be poked. Especially in the butt! :oke, pause, poke, pause, poke::

 

think I'm going to keep going an hour at a time until I see a rise--and then just do 0.2 (assuming it doesn't rocket up to 300 or something ridiculous).

 

lol, I'll get her up and put out some fresh food. Is this the thing where sometimes the pancreas kicks in when food is present?

 

Yeah, for whatever reason food seems to get the pancreas going. A few people have noticed recently that their cats tend to come down from higher than non-diabetic and lower than diabetic numbers if food is given. It lets you know quickly what to do, you'll either end up shooting soon or she'll go a while on you.

 

Yes, this is the thing. If she eats, test in an hour to catch the rise, then in another 90 minutes after that to see if it holds or drops by itself. That would be "P" doing the job nature intended.
Carl

 

Pancreas 101..... food causes the BG to go up. The pancreas puts out insulin. The insulin (if the body is working right) enables the cell walls to absorb glucose, which removes them from the blood, which lowers BG. It really isn't so much a matter of the pancreas producing insulin in a type 2 diabetic. The real problem is that the cell walls can't properly absorb the glucose unless you add insulin to the mix. If the cells can absorb on just her insulin, the BG remains under control. That's not the scientific explanation, just my understanding of the process.

Carl

 

she's so funny--when I plop her down by the food she tells me she is not interested and would rather I carry her around and cuddle. Then her sister decides she could eat a little bit, and suddenly she's hungry too. So she ate a little bit and is now back at her spot watching tv with me. So it's test in an hour and then again an hour and a half after that? and if it goes up on the second test, that's when I should give her 0.2?

 

Not sure of the % in cats, but in humans, 95% have type 2 diabetes.
I think it's 10% or less in cats.

Carl

 

I would test at 60 minutes each time, if it's gonna happen it should happen within the 2 hour point, that being said if it were me and i saw a huge jump in an hour I'd just go ahead and shoot.

 

Correct. But, if she skyrockets to 350 in an hour, then it's probably a good bet she'll need a small dose.

Carl

 

okay. Is it just any rise after the second test, or only shoot if it's over 200?

 

A confirmed rise that is big enough to not be all that close with variance, so your 172 would have to increase to 207 to be a confirmed rise of 1 point. That being said, the likelyhood of each of those tests being 20% high and the other 20% low is nil, so at some point you have to use your judgement. If at 1 hour you get above 200 I would test in 30 minutes and if you get another rise go ahead and shoot.

 

I agree. A rise that is outside of meter variance. If you get a 200, then anything higher than 225 or 230 in the next 30 minutes, that would be "rising" to me.

Carl

 

okay, will do. I'm going to leave this site for a bit to do some practice problems for my test, but I'll post the +1 after eating when the time comes. incase you guys go to sleep before then, thanks for your help!

 

I'm gonna grab my droid and head to bed, but I expect i'll be up still at about 1:10 here...I'll check in. Have fun!

 

okay, just got 204 at an hour after food, and +13.5 after her last shot

 

Wow, hope we didn't jinx it by calling it! Wait the 30 out and check again, if you don't get a drop in the next hour I'd go ahead and shoot.

 

recap
+11 201/186
+12 172
+12.5 she ate
+13.5 204

So she didn't come up much at all, and has been surfing more or less since +11.
Carl

 

shoot! I forgot to take away the food after she ate, and I just saw her walk in licking her chops, so she probably just ate again. I'll take away her food now and test again in an hour. if it's a lot higher I'll shoot, and if it's level, I'll wait another hour.

 

Actually she's been surfing since +8, 188!

Well, at least she's hungry! :roll:

 

Recap for the day, to compile:
AMPS: 371, gave 0.4u
+8 188
+10 163
+11 201/186
+12 172
+12.5 she ate
+13.5 204
+13.75 she ate again, more
+14.75 260, so I gave her about 0.2u

Will update this in the morning. Hopefully it'll be lower than the 371 from this morning!

 

How did I miss this? No biggie, since you did it perfectly! I'm betting the am number will start with a "2" rather than a 3.

Carl

 

at +11 (after 0.2), she was at 172! I'm very pleased. She was super hungry so I fed her now and will see where she is in an hour this could possibly be shaping up to be the best weekend ever--dare I dream to kick butt on the gmat, get snowflake off the insulin and then get to run off to london? if bad things come in 3's, do good things also??

 

oops! may have been too excited. at +12.5 she was 256 so I gave 0.25 (these micro doses are so hard!)

 

It'll happen sooner or later, if the .25 doesn't doanything to dramatic I would go to .3 for above 250 because the while units are so much easier. Don't know if you tried it, but when trying to get the correct dose if you twist the plunger clockwise it will move up very slowly and makes it easier tho get fine adjustments for small doses

 

thanks for the tip--I did not know that.

Just tested her and at about +2.5 she's at 241. I'm thinking definitely 0.3 next time she's over 200.

On another note--she totally slept through this test. She was napping, I went over to her, she kind of looked up a little bit as I initially did the poke, and then immediately went back to sleep. what a laid back kitty--so glad she's taken so well to home testing.

 

AMPS: 257, gave 0.25
+2.5 241
+3.5 249

 

You know, you had such a good run of numbers before...I would go back to shooting what you would have before the double up, you did a great job before. Just be vigilant about testing if she gets low and for a low number ps I would always see what the food does before shooting. I think that will keep you safer for the days when Mr. P is playing, you've shot a .4 into 165 on 4/8 and it was fine and gave you a good cycle, but then a .4 into 195 on 4/17 got you a little too much action. Maybe the food test would have let you know ahead of time on 4/17 that she was gonna drop on her own and saved you the drama.

*just to clarify, that 165 on 4/8 if you had fed and tested in an hour and it was 230 you would shoot the 0.4 based on the ps number and not the food inflated number.

 

AMPS: 257, gave 0.25
+2.5 241
+3.5 249
+7.75 169

Yeah, I don't want to stress her P too much more and it doesn't seem like it's kicking back in all the way just yet. I'd like to see some more numbers in the 50-99 range. Since 0.4 was a step down from the 0.6's and 0.5's I was doing, I might just stick with 0.4 for a while.

Question though, since I will be out of town and will be having a sitter come in to do one shot per day, is it fairly safe to assume that the freaky reaction to 0.4 was just because she was hyper sensitive due to the night before? If she's only getting one shot a day, I think I'd want it to be 0.4, not 0.2 (and 0.3 is tricky to find because my needles don't have 1/2 unit markings). But if it's likely that she could have a reaction to 0.4 like she did on the 17th, I clearly don't want that to happen when no one is home and I won't be back for a few days.

 

There's really no way of knowing what caused that, but with the huge drop by +1.75 I'd attribute it more likely to Mr. P kicking in. You have shot some fairly large for the ps doses into really low numbers with no ill effects, she's gotten really low some days yet not bounced from the lows. I wouldn't be too worried about her if she gets low, she seems to make it through it. I think you'd be fine going back to the .5 or .6 for the mid yellow ps number again, I would do as you were doing before basically, but let her run no shot through at least 150 so her P gets to try to figure things out. Hope she'll start pulling some really long cycles on you so the one shot a day will work out. I would just play it by ear still until you get closer to departure cause a lot can change between now and then.

Today is starting to not look too bad!

 

How is Ms. Snowflake doing?

 

She was 162 at 8am, so +10.5, then 204 at 10am +12.5. Before all of the mess, I would've shot at 204, so I shot slightly under 0.4 then. I would've preferred to do a food test, but I have MY test coming up and need to leave the house in 20 min! So, I'll test again when I get home afterwards and hopefully she'll be at least low 100's. we'll see. For now, I'm just hoping I can be in the 700's

 

Hoping for high 700s for you, and low 100s for Robbie!
Good luck today,
Carl

 

You've got a lot on your plate right now, glad you have a vacation coming up! God, wouldn't I give my right arm to be heading back to Europe....but too much work and 2 cats with crazy food needs. I like to go for 2 weeks at a time cause the biggest cost is the airfare and once you're there it's pretty cheap, plus I prefer not to take two 9-14 hour flights in the same week. Those trans-atlantic flights really suck, but the bright side is the alcohol is FREE even in coach!

Hope your test is going well!

 

oh man this girl is all over the place :sad: I just got home and she was 31 (at roughly +8)! She's acting fine. Their food was almost untouched, so I put out some of the fishy food she *loves* and she dove right in, so I'm hoping that will bring her bs back up, since maybe part of the low number was that she just hadn't eaten much. Guess the 0.4 for the petsitter isn't going to happen--maybe back down to 0.2 to be safe. As for me, I was very happy with a mid-700's number

 

As for Europe, I would give an arm and a leg to go for two weeks, but I can only get a week at a time off for work :\ Luckily I had enough airline miles that the airfare was just paying taxes and fees, and I have friends in London so I get to stay with them for freeeeee

 

and not 20 minutes later she is now at 51 (+8.5ish). Much much happier. I think tonight I'll see how far I can push it until giving her insulin.

 

A little low, but if she's acting normal I wouldn't worry at this point. A 31 a +5 or earlier scares me, a 31 at +8 after insulin has already peaked not as much. Especially because she's staying down, if it were a true hypo you would expect the liver to dump and numbers to quickly rebound high. She never seems to bounce after those really low numbers so I'm more inclined to believe that she "did it to herself", Mr. P kicked in and made some insulin and if it were truely too low he would have signaled the liver to take care of it. I have caught kitten that low since her last shot, so it is in the normal range for non-diabetics...just scarier I know on insulin. I was actually hoping she'd go low today, more like 60's or 50's, lets see how she handles that food...hope she stays down, don't throw a ton of food at her all at once.

 

Yeah, she seems fine :shrug: The food that I gave her was lc wet (plus literally 4 pieces of kibble)--I didn't want to throw hc food at her, since that tends to make things worse in the long run, I just wanted to get some food in her since it didn't look like she'd eaten in a while.

 

There's just never a dull moment, is there?
I'll be on for a while too, hopping between here and Health...

Carl

 

Okay, so last night she was at 256 at +12, so I shot about 0.3. However, I woke up to 336 at +10! I'm horrified, as I think what must have happened is that she probably went hypo and then had a bump, since there's no other reason for her to be so high. What should I do? I will be leaving the house at +11--should I shoot since she's so high, or not shoot, since it's likely a reaction to going hypo? oy vey.

 

well, there is no way of knowing really what happened. She could have had a bounce in the pm cycle from that 30 yesterday morning. I'd shoot before you leave, when will you be back? You can reduce just to be safe, 0.2 or something.

 

I ended up shooting 0.2. Just got home and at +10.5 she's at 329 so, I shot another 0.2. feeling extremely discouraged. Going to test every hour as late as I can stay up to see what's happening.

update: 372 at +2.

 

rise from eating and the insulin hasn't started working?

Carl

 

It's frustrating because it seems like 0.2 isn't nearly enough, but 0.4 sent her back into the 30's :\

PMPS 329, shot 0.2
+2 372
+2.5 356
+3 349
+3.5 309 (insulin kicking in)
+4 299

And she's been drinking a lot of water again.

In other news, Midnight, my non diabetic kitty seems to be going carb crazy! very infrequently, I'll give her a cheerio as a treat (maybe once every other month). My cheerios have always lived in their bags on top of my fridge. Tonight I caught her on top of the fridge tearing open a bag! They've always been there and she's never done that before! Shortly before that (maybe 10 min?) I caught her tearing into a bag of bagels! There's fresh food out, so what gives?! she's never done this before. I rebagged all of the cheerios and put those baggies in the fridge where she can't get to them. I'm going to post this on the health board too, incase this is some sign of disease or disorder or something.

 

Not sure about Midnight's recent fixation. Heck, my civvie, Mullet, decided he liked dark chocolate (at first anyway :lol: ) a couple of weeks ago. I've also caught him tearing into a pack of hamburger buns. He's just a piglet. He eats grits (and even I won't eat those)!


I'm thinking with the .2 vs. .4 dose, what happened when she went really low, or like today when she was flat, it's more due to something internal, whether the pancreas or her cells just absorbing the insulin better, that happens only randomly. That's the worst thing, you never know if or when "it" is going to happen, and when you are shooting such tiny doses, you wouldn't think it would matter too too much.... but it does.
Carl

 

I still cast my vote for the .4u for a mid 200, maybe 0.3u if she's 200. This is very much like Josie, anything less than a 0.4u doesn't really work and sometimes the 0.4 really works. I believe, like Carl, this is something internal and my vote is the P, P action always seems to be much more pronounced under 200. Since the P can also correct low BG and cause a liver dump, I don't worry as much unless we're talking about a huge dose. Snowflake has proven she can handle low numbers pretty well, your SS is amazing because you were able to hold her so low for so long...most cats would be bouncy as hell from going as low as she got. Also, 0.4u going into a 330 vs. a 204 is much different, I actually think you did better with the 0.65u on higher numbers like you were doing before. If this holds, give her a good dose next cycle and see if you can knock those symptoms back down, glucose is eliminated through the kidneys after about 250 which is why you're seeing the drinking/urine increasing, nip that in the bud as soon as you can.

 

Thanks for the continued checking in. she was 285 at AMPS, so I shot very slightly under 0.4. I'm going to try to come home at lunch to get a +5 reading--if it isn't under 50, that will give me confidence to give 0.6 again at these high numbers--I just hate not knowing how low she's going during the day.

 

At +5 she's 320. Something must be very wrong--it seems like the 0.4 is doing nothing. One question--I recently switched to shorter needles. Could that have anything to do with it? Maybe the insulin isn't getting as far into her body so it isn't being absorbed all the way? Either that or it's hitting her really fast and dropping her down and causing a bounce, but that doesn't seem very likely. Could the insulin be bad? I've had it since the first week of March, but it's never been out of the fridge for more than 5 min at a time.

 

Also, when you're in the middle of a cycle like that, and they're still so high--is there anything you can do to bring them down? I tried getting her to run around a bit and it worked for a few minutes, but that can't be enough to make any meaningful difference.

 

The shorter needles shouldn't matter as long as you're getting under the skin and you don't see any wet spots in her fur after the shot...

Unfortunately, you can't do much to lower her numbers in between shots. Exercise does help, but like stress, it's usually not a long-lasting change.
The insulin should still be good. How does it look? Do you see particles floating in it?

Carl

 

I would try a higher dose, if you shot somewhere around .3u it might not be enough.

 

When I came home at +13.5 she was 244. I shot somewhere between 0.5 and 0.6 after feeding her. Crossing my fingers. Depending on what she reads in the morning, I may try to stay home to do an hour by hour curve. At this point I'd almost prefer her go a bit too low just to give her kidneys a break. the insulin looks fine--still particles but I also don't know what wrong looks like.

+1 251
+2 249
+2.5 221
+3.5 178
+4 166

 

That looks better, did the numbers drop some more and hopefully she's still down? I think some of your cycles you just get a huge response from Mr. P and some you don't....see, no drop at +2 on this one? Mr P I don't think was playing around at this point, but he may have kicked in once the numbers got lower....Did she fall after +6?

 

+1 251
+2 249
+2.5 221
+3.5 178
+4 166
+6 107
+11 102!!!!!!!

Thank you for urging me to shoot higher! I think that may have been just what her P needed! If she was at 107 at the nadir, she probably didn't drop super low after that (I hope, at least), and it seems like her P must be working since she's stayed low. I'm going to see if I can work from home today so I can do the food test!

 

Correct, I don't think you got much lower after +6 and that is a hell of a surf she had. Agreed, food test and hope it goes well. For whatever reason I just see a lot of evidence that even if a cat has P function once they get above a certain 200ish number the P just says "forget it" and doesn't kick in again until the numbers fall....seems to be about 150 where you get some response. This is why I think you see cycles where a slightly lower dose doesn't do anything really, and just a slight increase that gets you down in the "P range" then does so much....even lets you surf a 100 like she's doing. I would go NS until over 150 and rising, if it's rising hard then hit it hard, if it's not then try a reduced dose like a 0.2. And wait at least 2 hours after you feed the test food.

 

And keep us updated!

Just to add that I think you can make judgements on dose on your own, you're a smart lady and you have a lot of data to look at. Initially your ss scared the sh*t out of me because the numbers were so low and you were shooting at such low numbers, but the reality is you have so much data that suggests snowflake tolerates that kind of dosing that I think it's okay (just give her a chance to self regulate and don't shoot below 150), it is just so much different then what we normally deal with. You've been doing an amazing job, and I do hope the numbers you were seeing are a result of her P working and not just your amazing work with the doses. I have a feeling today... ::antijinx::

 

+1 251
+2 249
+2.5 221
+3.5 178
+4 166
+6 107
+11 102
+12.5 147 (i think she may have eaten a little before I got home)

Just fed and now she's just kind of hanging out.

 

Well, guess we'll see what happens! If she gets up to 200 i'd try 0.3ish, the 0.4 has put you down in the 30's twice now the last couple times and the 40's are the very bottom of my comfort level with insulin on board. If she's higher I'd go with the same dose you did yesterday.