Viamo needs finer regulation: BG>400 (continuing old thread)

This is a continuation of this original thread.

Hello everyone!

I am Teo and @Ana & Viamo is my mother: we are from Argentina and we are owners of Viamo, a beautiful 10 year old blonde cat.

Viamo was diagnosed on october 2019 and we've been able to get his BG below 200 mg/dL for the first time only two weeks ago by changing his diet to wet food. He has peripheral neuropathy, (he can't use the tip of his back legs) which has not improved ever since. We've already been helped enormously by @Deb & Wink and other users of this forum at my original thread.

We've since learned a lot about measuring his blood glucose and giving him injections, and have also kept record of everything on his SS, which is also linked in my signature below.

For the last 3 weeks Viamo has been given a lower insulin dosage than before, because we were on vacation and left someone to take care of him. This was a measure to prevent hypoglycemia, as his nadir had been slowly going down and Viamo would be passing more time alone when we were away. This proved to be the correct thing to do, as Viamo reached the first numbers under 200 (and even under 100) when we were on vacation.

Now it seems that we've lowered the dose too much (2 units every 12 hs) and @Deb & Wink has suggested that we should start using insulin syringes to regulate the dosage in a finer way. We only have 20 insulin syringes with half-unit markings and we've had problems finding them on sale here on Argentina, but we could start trying them out soon if this is the only way to keep Viamo regulated.

Thank you so much for your help.

 

Spanish is Teo's primary language, but he writes well in English. Teo's mom Ana struggles a bit more to read English, so I have been doing the original post in English and then the google translate version directly below that to help out Ana.

El español es el idioma principal de Teo, pero escribe bien en inglés. La madre de Teo, Ana, se esfuerza un poco más por leer en inglés, así que he estado haciendo la publicación original en inglés y luego la versión de traductor de Google directamente debajo para ayudar a Ana.

 

Teo, 60 syringes would last you 1 month. That will be a good start.
Teo, 60 jeringas te durarían 1 mes. Ese será un buen comienzo.

Did you watch the video on withdrawing insulin from the pen using a syringe?
¿Viste el video sobre cómo extraer insulina de la pluma con una jeringa?

How to Draw Insulin from a Pen or Vial With a Syringe
Cómo dibujar insulina de un bolígrafo o vial con una jeringa (Video de Julie & Punkin)

 

Hi Deb, it has been very kind of you to do translations for me, but it is not necessary for other users to do so. I can always translate sentences myself if I have doubts. Now that Teo is back home he will be the one writing on the forum anyway.

 

This was a mistake!! We only have twenty syringes. That's a lot less.

I edited the original post.

 

Put him right back to work Ana! No rest for the weary traveler.
¡Ponlo de vuelta a trabajar, Ana! No hay descanso para el cansado viajero.

 

How difficult will it be to get more than the 20 syringes you already have?

 

I think a dose of at least 2.25 Units is needed for Viamo.
Creo que se necesita una dosis de al menos 2.25 unidades para Viamo.

 

Hola y bienvenido.

If the insulin syringes with 1/2 u markings are not easy to find, maybe you can use an old one to get a feel for how many drops you can squeeze out between the full and 1/2 unit markings. Just use some coloured water to see the drops. I usually count about 4 drops between a full unit to 1/2 but each person might have a slightly different count. Then, if you are in short supply of the 1/2u needles, you could draw up a little extra and squeeze out the drops.

We tend to go up and down in smaller doses (by 0.25u), but I understand why you reduced while you were away. It may be that Viamo was lower last night, since he started today with AMPS 254. But even with this, the rest of the numbers say more insulin is needed. I think you should increase to 2.25u tomorrow. Remember, many kitties like to go lower at night, so we often suggest getting one test before bed every night if you can.

 

Hi @Christie & Maverick , we've finally been able to find syringes with half-unit markings!

My only question is: they have 6mm needles. Are theese not too short to give subcutaneous injections for a cat? We have always used 8mm needles with our insulin pen, and I remember a vet telling us that needles that are too short are no good for cat's skin.

We have administered the first 2,25 U injection, but I'm worrying about the length of the needle.

 

Also, I'm pretty sure I've not seen syringes that have both the 1/2 u markings and have longer needles integrated.

 

Teo, insulin syringes with the shorter 6mm needle length can work well for insulin injections.

Do you know how to "tent" the skin to get the needle inserted?

@Christie & Maverick They do not have any "old syringes". Teo and his mom Ana only had the insulin pen with the 'dial-a-dose" feature.

 

Estupendo, I'm glad you found them! Actually many people here prefer the 6mm length needles, so you shouldn't worry at all about that. Buena suerte with the new dose.

 

Great! We'll keep up the new dosage and wait to see how Viamo reacts to it. We might also test him more at night.

 

If by "tenting" you mean pinching the skin with your hands to get it tighter in the point of injection (as if "making a little tent" with his skin), then yes, that's what we do. My mom says she didn't have issues with the first 2,25 injection this morning.

 

That is what we mean by tenting.

It is so good that your mom Ana is helping test and give Viamo insulin.

Teo, do you think you could help your mom get a signature in her user id? We'd want to see the same information in her signature as you have in yours, including the spreadsheet (SS) link.

Teo, ¿crees que podrías ayudar a tu madre a obtener una firma en su identificación de usuario? Queremos ver la misma información en su firma que usted tiene en la suya, incluido el enlace de hoja de cálculo (SS).

 

Done!

 

You don't seem to be getting much guidance over here in the Lantus ISG (insulin support group).

Maybe post a new thread for the day, link this old one at the top and ask people to look at the SS for Viamo and make suggestions.

You need to post to get attention in this forum. Very different than in the Feline Health forum where people are more proactive about replying to you.

Here in this forum, the responsibility is placed on you to ask for and get attention on your posts.

So new post, daily or every couple of days.
Instructions for posting here:

Daily Threads & Posting Instructions for this forum:

• Please use one thread for all your comments and questions you have that day since this forum is so busy. This will keep all pertaining to your cat together everyday.
• Start your thread with the date, kitty's name, and AMPS
• Your thread will be bumped to the top of the list when you or anyone else posts on your thread.
• The 911 prefix in the subject line should only be used for emergencies such as symptomatic hypos, very low numbers (below 30 on a human meter), and/or very sick cats potentially needing ER care. Please remove the 911 as soon as someone has responded and you have received help.
• Link your previous day's thread at the top of your post.
• Update the thread title with BG tests taken during the day

For example:
2/15 Viamo AMPS 357 +2 Dose suggestions? Testing suggestions?

You may want to consider using the TR (Tight Regulation) protocol.
I had you start on the SLGS (Start Low Go Slow) protocol.
That was because of the food change, your upcoming vacation, your pet sitter situation.

I think Viamo could benefit from the TR protocol. You and your mom are able to test enough. Viamo is ok with the testing process. We need to get the insulin dose adjusted so Viamo's neuropathy can improve.

Need some blood glucose tests during the middle of the cycle to see how this 2.25U dose is working for Viamo.

 

Thanks for clearing up the way the forum works for me. I hadn't noticed that one should have a separate thread each day. I'll do that now.

Also, I don't know what exactly constitutes the TR protocol. I'll try to get more users' attention.

 

Also, what does the +2 refer to in your example? You mean I measure him again and put that in the title as well?

 

Start a new thread in this forum and I'll answer you there.

Ok?