Spicoli pt1

Discussion in 'Prozinc / PZI' started by Wesley and Spicoli, Apr 25, 2017.

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  1. Wesley and Spicoli

    Wesley and Spicoli Member

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    So today was day 5 with no need for insulin. He's just getting over a bout with pancreatitis, but his numbers have been the best and most consistent since dx.

    Besides continued testing and of course insulin if necessary what should my next steps be?
     
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  2. Cherish Gallagher

    Cherish Gallagher Member

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  3. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I believe that after 14 days without insulin you can say your kitty is officially "off the juice". You can post on the main health forum to see if there are other criteria.
     
  4. Djamila

    Djamila Well-Known Member

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    Recommendation is to continue testing for 14 days without insulin. After that, you can start to spread out the testing more, but continue to monitor for the rest of the cat's life. Some say to test weekly, some say monthly. Cats can go out of remission quickly, so I would recommend about every two weeks. A cat who doesn't need insulin will always be considered a diabetic, but now a diet-controlled diabetic. So always be very careful about food choices going forward. I got a little complacent and we ended up back here again. Also keep an eye on thirst and increased urination as they may be your 1st clues if his glucose starts rising. Also keep an eye on your kitty's weight, as that is a contributing factor in FD.

    Congrats on the great numbers so far!!! Fingers crossed they keep going that direction!
     
  5. JanetNJ

    JanetNJ Well-Known Member

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    Very cool! Good luck
     
  6. Caitlin M

    Caitlin M Well-Known Member

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    Wooo! Good luck :smuggrin:
     
  7. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Grats! *paws crossed*
     
  8. Wesley and Spicoli

    Wesley and Spicoli Member

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    Thanks! I think we'll need it. I'm just positive he'll throw me a curve ball tomorrow.
    I know he will always be a diabetic but hopefully we can keep him diet controlled. I have NO plans on changing his diet or our civies since this is the diet any cat should be on.

    Paws and fingers crossed!! And knock on wood!! Either way we've been headed in a pretty positive direction either way :) But who can't hope for OTJ!!!!
     
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  9. Rachel

    Rachel Well-Known Member

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    Wahhoo!!!!!!!!
     
  10. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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  11. Wesley and Spicoli

    Wesley and Spicoli Member

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    As expected he threw me a curve ball the next morning.

    So I have a question. This morning his bg was 388. I think that's the second highest we've ever been. I gave his .25u (earned an official reduction 4/27 when he hit hypo numbers on .5) and tested when I got home from work- +10 254. His PMPS was 105 so I thought no way and tested about 1 min later and it was 133.

    Is this normal? I don't think it was a bounce and we've gotten great numbers from .25u before.
     
  12. Rachel

    Rachel Well-Known Member

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    Woah! That's really odd. I'm wondering if the 254 you got at +10 wasn't a wonky strip or something. It seems really odd that he would go DOWN over 100 points at the end of the cycle.

    Any chance you could run a curve soon? I'd really like to see what his numbers do over a cycle.
     
  13. Wesley and Spicoli

    Wesley and Spicoli Member

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    Ahhh... I won't have a chance to run a curve till Sunday. But I can and will Sun/Mon. This past sun/mon was all wonky, so I wasn't around like I usually am. At most till then all I can get is a +2, +10.

    He usually is lower in the evenings but dropping that much after eating his afternoon snack, no way.

    I'll tag you Rachel when I can get a curve in.
     
  14. Rachel

    Rachel Well-Known Member

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    That's fine! If you can grab those extra tests when you can this week and then curve this weekend, that'll give us some good info to hopefully see what's going on!
     
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  15. Wesley and Spicoli

    Wesley and Spicoli Member

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    So the past 8 days I haven't been able to control Spicoli's numbers. After our hospitalization my vet and I had a long talk since the cat bounces around alot. He said I should continue to increase his dose until the numbers came down. I'm worried that this is why he's staying so high and we're seeing numbers that we've never had before.

    I could just use some advice from all you prozinc pros out there. Starting over, gradually reducing, whatever.
    Any advice is greatly apprectiated :)
     
  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Usually a cat that starts having high numbers after no insulin for a while has another issue going on - UTI, need for a dental, food change, etc. Is there anything happening with your kitty that's out of the ordinary?

    Yes, he is bouncing a lot and frequent dose changes can make that worse. How about trying a set dose AM/PM for two/three days, then increase by 0.25 u if that doesn't help. Why not backtrack to 0.25 u BID because that's where this began a week ago. After two/three days, go to 0.5 u BID and so on. What we know for sure is that throwing more insulin at a bouncing cat doesn't help.
     
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  17. Djamila

    Djamila Well-Known Member

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    Yes, start over. The dosing is all over the place, and you have numbers that indicate bouncing and possibly too much insulin. I would say back down to 0.5 units and let's see how that does for a few cycles. I would also really encourage you to keep testing and posting (you're doing great on the testing!). Dosing is much more complicated than it might seem, and having some other folks looking at your numbers and making suggestions will help get this sorted out.

    It's also possible that there is something else going on. Have you had your cat's teeth checked recently? Any chance there is a UTI or something else going on?
     
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  18. Djamila

    Djamila Well-Known Member

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    Oops. forgot to hit refresh before I posted. Looks like Kris said pretty much the same thing! I think it would be fine to go down to 0.25 as she suggested and move up from there. It's usually better to err on the side of caution.
     
  19. Wesley and Spicoli

    Wesley and Spicoli Member

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    He's no longer an indoor/outdoor so I can monitor him better - this has been a challenge and im sure stresses him. He's urinating fine and not frequently. I had his teeth checked on the 6th of this month after our hospitalization. Said no need for dental. Food is the same. He does have IBD (recently dx) but nothing seems out of the ordinary.

    Will start over tonight.
     
  20. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Good plan. IBD is an inflammatory condition so it might affect BG. Is he getting meds for it? You can still find a good dose range though.
     
  21. Wesley and Spicoli

    Wesley and Spicoli Member

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    He isn't currently getting meds... actually i guess his food isnt the same. We're still feeding low carb (according to the amazing food chart) but trying duck, quail, rabbit, venison, and other proteins he hasnt had before. Just trying to stay away from chicken/turkey. Vet is looking into Texas a&m lab to see if they're doing any trials since he is the perfect candidate, but either way we're going to be sending off a serum sample to see if it can shed some light on if this is IDB or something more sinister. But no steroids yet. His IBD symptoms have greatly improved since adding in FortiFlora and changing proteins.
     
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  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    All good as far as BG effects. Any low carb food should be good and there are no meds to cloud the picture. :)
     
  23. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    I like what Kris and Djamila have suggested. Hopefully we can help you get to the bottom of this :)
     
  24. Rachel

    Rachel Well-Known Member

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    Sounds like you have a good plan to go forward with!
     
  25. Wesley and Spicoli

    Wesley and Spicoli Member

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    We are on our 6th cycle of .25 but his numbers haven't come down too far. Haven't had time to do a curve on this dose but I could do one today, or at least a partial. Should I go ahead and move up to .5 or give it some more time at .25?
     
  26. Rachel

    Rachel Well-Known Member

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    Why not go ahead and run the curve today and then we can decide from there?
     
  27. Wesley and Spicoli

    Wesley and Spicoli Member

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    so ive only done +2 +4 so far but his numbers have already started to go back up... amps 461, +2 402, +4 452
    also i made sure the insulin wasnt bad and bought a new bottle... ive had the same results with both.
     
  28. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Time to go to 0.5 u in your "starting over" experiment. Hold for no more than three cycles if you get no positive effect. The longer he stays in high numbers, the harder it can be to shift him. I'd also keep an eye out for anything that might be bothering him that could explain his bump into higher numbers.
     
  29. Wesley and Spicoli

    Wesley and Spicoli Member

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    Still no improvement with his numbers..(ss not fully updated) Noticed an ulcer/sore on his mouth this morning so we're going in to get checked out today. Unfortunately his vet is gone for the rest of this week and next so we're going to have to see our backup. Either way maybe a blood panel/ urinalysis will shed some light on what's going on with our problem child. Will update after our visit.
     
  30. Djamila

    Djamila Well-Known Member

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    A vet visit and some lab work is a good idea. Assuming everything checks out, just keep going with the increases, but we usually recommend holding an increase for 3-6 cycles before making the next move up. Sometimes cats don't show a response for the first couple of cycles. Since his numbers are so high, I would aim for the lower end of that and just hold for 3-4 cycles though.

    Honestly, you almost hope there is something else going on and a quick round of antibiotics or a dental cleaning could get him back on track! Please keep us posted on what you find out from the vet. Any idea what causes mouth ulcers in cats? For humans it can be iron deficiency or B12 deficiency, but I don't know if that's true for cats too?
     
  31. Wesley and Spicoli

    Wesley and Spicoli Member

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    Im hoping its an infection or something we can easily deal with. There are "rodent ulcers" but aside from that I have no idea what can cause an ulcer in cats. Maybe the feline version of herpes? I don't think it's feline acne but I suppose it *could* be. There was a little bit of puss that come out when accidentally touched it this morning, but he was pawing at it so I had to look. Today may also be the day we have his blood serum sent to Texas A&M concerning is IBD. Our primary vet wanted to start here before doing surgery for a biopsy since he's older and has FD. Maybe this will also give us more of an idea if it really is IBD or intestinal lymphoma.
     
  32. Wesley and Spicoli

    Wesley and Spicoli Member

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    So the vet visit went well. His labs were completely unremarkable. He did have a little plaque around his gums but the vet said it shouldn't be the cause of his high numbers. Also, what I thought was an ulcer, he thinks is just acne. As of now the vet thinks the high numbers are due to the Somogyi effect and recommended that we go back down to .25u for 1 week and see where that takes us. If his numbers don't move then we will be going back and exploring other possible causes.
     
  33. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Glad Spicoli's labs were good, is the ulcer inside his mouth like soft tissue or on his gums? I'll give my thought on the ulcer after hearing confirmation:)
     
  34. Rachel

    Rachel Well-Known Member

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    Hmmm...I don't know if I would start over at 0.25 if it was me. You've done that recently and showed that the numbers were staying high and flat, which is not a sign of somogyi (which we call bouncing). Did your vet get to look at your SS and see that you've done that? I guess my thought is you've done it, so doing it again isn't really helpful, but staying the course of constant, steady increases will help you get there.

    It is, of course, ENTIRELY your decision, but just wanted to voice my thoughts. :) If you do decide to go back, please make sure you're getting ketone tests as often as you can. Those higher numbers can be one of the causes of ketones (not for a SECOND saying he's got them or will get them, but better safe than sorry!). The earlier you catch those the better if they happen.
     
  35. Wesley and Spicoli

    Wesley and Spicoli Member

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    I haven't quite decided what to do yet. I'm leaning more towards staying a 1u for a few more cycles. I didn't bring him my SS but he knows that I home test and I did tell him about what had been going on and the rough numbers. So basically he thinks that cat is bouncing. Going back and starting over at .25 now is a waste of time and insulin lol. But seriously. I do ketone tests but according to the ss it's been a week so I'll try to grab one tonight if possible, if not in the morning.

    I will say the cat has been acting pretty good aside from his IBD and the once a week (ok maybe 2 times) vomit. I do give him 1cc of Metoclopramide if he throws up. He's actually gained weight in the last 2 weeks.

    Any thoughts from you guys? Should I stay at 1u or maybe back down a little and give those doses more time?

    There are only 2 cycles on the ss but we've done 3, and they've all been the same - high and flat.. Just havent logged those numbers.

    Well neither. I guess it isn't really an ulcer, more of a sore. It's on the outside on his lower lip.
     
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  36. Wesley and Spicoli

    Wesley and Spicoli Member

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    Just did our pmps test 379!!! It's still high but an improvement nonetheless.
     
  37. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Hmm guess it could be a cold sore or acne. Vet didn't say to put anything on it?

    Yay for improvement on BG tonight :)
     
  38. Wesley and Spicoli

    Wesley and Spicoli Member

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    Vet said I could, but that because of where it is he would just lick it off... It's right and the upper edge of his bottom lip. It doesn't look bad but I have a tendency to overreact and was looking for ANYTHING that could be keeping the bg lvls elevated. It's no bigger than well... it's really small. No bigger than the biggest blood drop I've ever gotten from poking his ear.

    And yes YAY! I think I'm going to stay at 1u for a couple days and see how that goes. Thoughts?
     
  39. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    I think staying at 1.0U for a couple more days is way better than back tracking to 0.25U. :)
     
  40. srk4cats

    srk4cats Well-Known Member

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    Is it a little lump on his lip? Pogo had one and I had it surgically removed. I should have spent the $100 to get it biopsied because Pogo died of cancer a year later. He once had acne from eating out of plastic bowls, but that was just small pimple-like bumps. It sounds like that's what it is and antibiotics should clear it right up.
     
  41. Rachel

    Rachel Well-Known Member

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    Nice PMPS!!!! I think I'd stick with 1 too...especially after getting a lower PMPS last night!
     
  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I like the idea of staying at 1 u and increasing carefully as needed.
     
  43. Wesley and Spicoli

    Wesley and Spicoli Member

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    It isn't a lump, it's just a little sore. ANY lumps we have checked biopsied and/or aspirated. I completely freaked when I first found his lipoma, but luckily that's all it was. And he has a little mole beside the top of his ear. I had that checked too :)
    I haven't checked his sore today yet, but if it doesn't improve/gets worse we will have it biopsied within the next week. Side note - I don't feed them out of plastic bowls - just ceramic bowls for water/dry food and plates for wet food.

    He was a little high this morning at 427 but he is always higher in the morning. I think i experience the dawn effect with him, as even the stretches we've not needed insulin he was still higher in the AM vs PM.

    We've been at 1u for 5 cycles now. Going to run a curve today and try to grab a ketone test. I think I may hold for a few more cycles, but I think 1.25u might be our magic number as it sent him into the greens 2 weeks ago. Just don't want him to start bouncing again. I really think that his super high 500 numbers were a result of too much insulin so I will proceed with extreme caution. I guess that's why I want to stay a 1u for a little while longer.
     
  44. Wesley and Spicoli

    Wesley and Spicoli Member

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    Quick question to go along with everything. My ER vet (i really like) fussed at me for feeding him more than just 2 times a day saying it would be harder to control his numbers. He has breakfast, maybe a snack around noon and 4 (when I'm home or free feeds on wet/evo dry when I'm gone) then nothing till pmps around 8. Spicoli is back up to his target weight at just over 14 lbs and there's no way he can eat half of what he should in the am or pm. I always thought that feeding more than 2 times was acceptable am I wrong?
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It's acceptable here but many vets promote feeding only twice a day. It's like a lot of other things we recommend here that are at odds with vet recommendations. I say the proof is in the pudding. :)
     
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  46. Djamila

    Djamila Well-Known Member

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    If I only fed Sam twice/day he would eat me! He needs food all day long. Human diabetics usually eat several snacks during the day to keep their numbers level. It's the same idea.
     
  47. Wesley and Spicoli

    Wesley and Spicoli Member

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    342 amps!! lowest in nearly 2 weeks!! i havent been home today so no extra tests but will update for pmps and hopefully do a curve tomorrow.

    That's exactly how this one is. He'll howl his head off if there's no food to be found. I tried 2x daily (had to do it with our other 2 as well) and it just didn't work for any of us.
    Our civvie Addy would scarf and barf, Taco would be left with nothing because of greedy little Addy, and I felt Spicoli was never eating the right amount for his target weight. He had dropped down to under 11 lbs (he's a big kitty) and the vet wanted to see him back around 13-14 lbs. With the issues we've had with his FD, stomach ulcer, and IBD I was afraid he'd never get back to that, but Wednesday he had hit 14! yay!!
     
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  48. Wesley and Spicoli

    Wesley and Spicoli Member

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    Oh one more thing. We're at 1u and we've been here for 7 cycles. I just tested and at +8 he's way up - 517. Should I hold at 1u or bump it up to 1.25? Or could this be a bounce?
     
  49. Djamila

    Djamila Well-Known Member

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    I suppose it could be a bounce, but I don't see any other data that would suggest he's going lower, so I would be more inclined to think an increase is a good idea. If you're going to be monitoring tomorrow anyway, I'd think it's a good time to try an increase.
     
  50. Wesley and Spicoli

    Wesley and Spicoli Member

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    Yeah I really doubt it was a bounce...just has me a little confused. He didn't eat while I was gone so I don't understand how his bg can be so high. I guess that's why they call it a sugar dance.

    Will up to 1.25 tonight and get at least a +3, and curve tomorrow.
     
  51. Djamila

    Djamila Well-Known Member

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    You might consider waiting for the increase until tomorrow. Last time you did 1.25, he hit green (6/23 PM cycle). Either that, or I would stay up past +3 to monitor. It's always better to err on the side of caution.
     
  52. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Did you retest by chance? I've had a random higher number than usual patterns and when retested, got a more expected number. :)
     
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  53. Wesley and Spicoli

    Wesley and Spicoli Member

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    I didn't retest... And I did move up to 1.25 last night and stayed up to get a +3 but he only went from 471 pmps to 417 @ +3.
     
  54. Wesley and Spicoli

    Wesley and Spicoli Member

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    So we've been at 1.25 for 4 cycles and I've not seen any real improvement in the numbers. Should I hold here for a few more cycles or bump him up to 1.5?
     
  55. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you can go to 1.5 u next shot.
     
  56. Wesley and Spicoli

    Wesley and Spicoli Member

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    That's what i figured... I'm at such a loss with this kitty. Thanks for all the advice :)
     
  57. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Just keep up the careful dose increases of 0.25 u at a time. No longer than 3 cycles at an ineffective dose.
     
  58. Wesley and Spicoli

    Wesley and Spicoli Member

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    Just a little update -
    So after a little over a week since our vet visit, still no changes. We went back to the today. Looks like he has an ear infection and an upper respiratory infection. The scope Dr. A used to look in his ear was covered in gunk when he withdrew it from the ear, so doing a culture on that. I know his blood panels last week were unremarkable but I feel like the vet we saw just didn't do a thorough physical examination. He was also dehydrated from his numbers being up so high for so long. So we're doing another blood panel, urinalysis and some IV fluids. He's staying over night tonight but hopefully once we get these things taken care of his numbers will start to go back to normal.
     
  59. Djamila

    Djamila Well-Known Member

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    Oh, I'm so glad to hear he's getting a better exam! Sorry to hear about the possible infections, but maybe those will help to get some traction on the BG levels. Please keep us posted on what you find out. Why is he staying overnight? Is it to get the fluids?
     
  60. Wesley and Spicoli

    Wesley and Spicoli Member

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    It sucks that he could have a few infections going on, but I'd rather those be the cause of his high BG readings than other possibilities. I think Dr. A wanted to keep him for the fluids and to probably try different insulin doses. His vet has never kept him except for when his tummy ulcer was bleeding and the kitty was vomiting blood. He even let me take him when he had pancreatitis. So when he wants to keep him I don't really object. But I should find out something this afternoon and will update.
     
  61. Wesley and Spicoli

    Wesley and Spicoli Member

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    Well just got off the phone.. Vet had left already and the techs couldn't tell me much. They gave spicoli 2u of insulin and he came down to 176!! Made me so happy to hear that. They did a culture on the puss from his ear but the tech didn't know what was found out about it. So far he hasn't been put on antibiotics. So he's staying for iv fluids and a recheck in the AM. I'll know more once I get to talk to his vet tomorrow...

    But it makes me wonder why he didn't come down for me on 2u and he did at the vets when usually his BG would be elevated. Our sugar cats are odd creatures.
     
  62. Rachel

    Rachel Well-Known Member

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    Hmmm...who knows why he came down? He could be feeling better from the fluids he's been getting. Looking forward to hearing the update tomorrow!
     
  63. Djamila

    Djamila Well-Known Member

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    Is there any chance your insulin is old/has gone bad? Floaties?
     
  64. Wesley and Spicoli

    Wesley and Spicoli Member

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    I wish. I bought a new vial to check them against each other, got the same results. The "old" bottle is almost gone, but no floaties. They both look the same. Even got my pharmacist dad to check them. Busted out the control solution and tested the meter - was in appropriate range. I went through all the steps to find error on my part (or insulin) and really came up empty handed.

    Talked to our vet this AM, and Spicoli has been doing much better. He's been eating (never does this when he stays), drinking, talking, going to the potty, and acting like a happy kitty from what I've been told. Vet wants to try 2u AM 1u PM. They were running a curve today since he's still there and still on IV fluids. He had about 1/3 of a liter left the vet wanted to get in him. Dr A suspects that the infection could have been stressing his little body and keeping his numbers up. I'll be monitoring him closely with this new dose of course.

    I do have a question on earned reduction. At what point do you guys reduce? Before, if he hit a hypo number I reduced by .25u. Is this correct?
     
  65. Rachel

    Rachel Well-Known Member

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    In Prozinc we usually reduce if they hot lime green during the cycle.

    Glad to hear he's feeling better! Hope it continues.
     
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  66. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Glad he's doing well but I'm still leary of the varied doses; 2.0U for AM dose and 1.0U for PM dose. I was going to say, why not 1.5U for both but you've been doing that :smuggrin:. Next step would be to try 1.75U for both but it's totally your decision! :bighug: If it helps him and works, then that's great!

    And Rachel clarified when to reduce ;)
     
  67. Djamila

    Djamila Well-Known Member

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    I don't mind the varied AM/PM dose. My kitty was on slightly different doses quite often, though never quite a whole unit. If it doesn't work, you can always re-balance them, and who knows, it might help!

    Is he taking anything for the infection, or just hydrating and letting it run its course? Hoping he feels all better soon!
     
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  68. Wesley and Spicoli

    Wesley and Spicoli Member

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    I just picked him up and wow! He seems so much better!! Went right to eating once I opened a can of duck for him. I know he's not "well" yet, but seems much improved.

    I guess after they finished the curve today the vet changed his mind - 2u bid. But either way for the next several days I'm going to do my own partial curves during the day and try for +4 pm.

    We do have drops for his ear - Tresaderm 5 drops bid for 7 days.

    And thanks Rachel! That's how I had done reductions in the past just wanted to make sure I was doing it properly :)
     
  69. Wesley and Spicoli

    Wesley and Spicoli Member

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    Feb 16, 2017
    We had our recheck today. Vet wants to up his dose to 3/3. While I agree another increase is needed, a whole unit not so much. If you go by the math - for every 1u he drops ~100 pts. it makes sense -
    but i feel like that might be too much.

    I know protocol says .25u increments. On the same hand I don't think a .25u is going to take us very far. What do you guys think about 2.5u? Or should I just stick to the .25u increment?

    I guess I'm being a little aggressive regarding his insulin, but he's been hanging out in these high numbers for soooo long.
     
  70. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    While in general we preach slow and steady in the interest of keeping cats safe, there are times when aggressive dosing is appropriate. Looking at your spreadsheet and the insulin responses so far, I think this is one of those times, as long as you are able and willing to monitor. You do a great job of that during the AM cycle, but I would encourage you to be vigilant during the PM cycle since many cats run lower at night.

    The protocol at the top of the Prozinc page actually advocates for 0.5u increases for cats who are high and flat, with flat being less than a 50% drop. It looks like Spicoli qualifies.
     
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  71. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    I guess I forgot about this, haven't looked at the protocol page in a few days.
    Thanks for the reminder :)

    I'll try to stay up a little extra late tonight and get a +3 +5 since I don't have work tomorrow and we're increasing.
     
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  72. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    No worries at all about the protocol! I've been on here off and on since 2015 and I still find things in there that I've missed or forgotten! I just looked now because I like to double check before suggesting something out of the ordinary. And to clarify about the evening cycle: please make sure you are getting enough sleep. I never want someone to miss sleep (so essential to our physical and emotional health!) unless it's absolutely necessary (kitty dropping quickly, for example). I just meant to try to grab a test as late as possible before you go to sleep. But please go to sleep whenever you need to! :)
     
  73. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Don't worry I do :) I've been home alot lately due to some medical issues/new medications so I've been seriously catching up on sleep. I'm the type that will push everything to the side to get my 7-8 hrs. I turn into a grumpy 3 year old if I've been up too long. But I'll be up anyways till at least +4 and can make a decision then if I should set an alarm. His nadir is usually around +5 so a +4 should give me a good idea where he's headed.
     
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  74. Yong & Maury GA

    Yong & Maury GA Well-Known Member

    Joined:
    Jan 11, 2017
    I'm inclined to agree with Djamila for this instance, especially since you'll be monitoring him. Hope the 2.5U at least shows you some blue :cool:. Hope your new meds are helping you as well :)
     
  75. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    No blues yet, but we've had a much better curve today.
    He still isn't coming down 50% so should I stick with the 2.5 for a few more cycles or go ahead and bump him up to 3?
     
  76. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hooray for yellow! I would hold the dose tonight, and if nothing dramatic happens, increase tomorrow. At that point you may get some bouncing and need to hold the 3u for a couple of extra cycles.
     
  77. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    ...mmm....actually, I'm starting to rethink that. Those yellows are lower than he's been in quite awhile, and kind of by a lot. You may get a bounce tonight. Let's hang on and see what happens before making a decision...
     
  78. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    I know right! It's so hopeful for me I just want to get him lower...but I know these things take time. I guess I'm a bit impatient.
    I was really nice to see him acting more "normal" today with these lower numbers.

    And his ear seems to be doing much better. The only time I see him pawing at it is right after we do drops :) So maybe as that heals his numbers will continue to go lower.
     
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  79. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    I agree that we should wait and see. Those yellows are a good 100 points lower than you've been getting...let's see what happens before deciding. :)
     
  80. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    So it doesn't look like he's bouncing - at least to me. I didn't get any tests last night...fell asleep early. I managed to snag a +6 today and it's pretty much the same as before. Unless you guys think I should hold off I plan on going to 3 tonight since he still isn't quite dropping by 50% at nadir.
     
  81. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Nice cycle today! Yup, I would go for it. You're getting some good insulin responses now, which is great, but you're right that those nadirs still need to go lower.
     
  82. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    It's so nice to see him responding again :)

    I'm thrilled at our yellows, but I'd love some blues and might roll over and die happy if he'd throw me some greens :)

    I can't thank you guys enough for helping me get him back on track.
     
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  83. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    My kitty is mysteriously climbing right now too, though not as dramatically as Spicoli. :( Fingers crossed we can both get out kitties headed back in the right direction!
     
  84. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Aww I really hate to hear that. Did you just switch over to Lantus?
    Gotta say I'm pretty envious of his SS!! Looks like you 2 have really made alot progress over the last few months. Hope Sam comes back down :)
     
  85. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Yes, just switched. I was blaming the Lantus for the climbing numbers the first few days, but now I think it was just an unfortunate coincidence that I switched just as he started rising. Although I do kind of wish I had just stuck with the prozinc. I felt a lot more in control with that, and right now, i could really use a little control!
     
  86. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    We had to shoot late last night, so I have to shoot 2 hrs early today (have to be at work early and he escaped last night). However he's at 234!!! Yay!!
    But what should I shoot?
     
  87. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Are you shooting and running out the door? Or will you be able to get a +2 or something?
     
  88. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Shooting and running unfortunately.
     
  89. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    If you have time to get in one more test before you shoot to make sure he's rising, then you could probably hold the dose. His nadirs haven't been very low, so even if he drops lower than normal, he should be fine. Do you still free feed wtih EVO? As long as he has access to food, he'll most likely just go eat if he starts to drop too fast.
     
  90. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Or maybe a little less, like 2.25? You are catching him at a much lower PS right now since it's early. How many hours since last night's shot?
     
  91. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    It's been 9.5 hrs. There's evo out during the day, yes.
     
  92. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Maybe I'm being too cautious but hows 1.25u sound?
     
  93. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Checked again he's at 249.
     
  94. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Yes, if you're not even past +10 yet, I agree that cautious is going to be better.
     
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  95. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    He isn't even really rising yet. I would go with the lower dose. He'll probably be higher tonight, but you'll get him back on track this evening.
     
  96. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Awesome! 1.25u it is.
     
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  97. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Have a good day at work!
     
  98. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Oh gosh I'm gonna need it. Today and the next 9 are the busiest 10 of the year :)
     
  99. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Got home earlier than expected and at +6.5 he was 431. So I'm not sure if this is from the reduced dose or if he's bouncing a little, but either way he was alive :)
     
  100. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    My guess is that it's the reduced dose. Most likely onset of the morning dose hit at about the same time he spiked at the end of the cycle. With less insulin to help him out, he's going to run high. But here's the thing: it could have gone the other way. Some cats would have taken that and tanked. So this is data, and next time we'll have a better guess on the amount of the reduction. It seems like most of the time with this dance, we only know in hind sight...

    And hooray for making it through Day 10 in the Busy Days Countdown 2017! :D
     
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