Week One completed!

Well, we made it through our first week...Jack was diagnosed 1 week ago today.

Preshoot numbers are still very high in the reds, but his other numbers are looking great. I made a slight increase to 1.2 u for both shots today, and I'm hoping to do a complete curve this weekend. One more day of antibiotics left. Bought an automatic feeder on my way home from work tonight so it will make it easier to have some food out for him during the night. Any other suggestions are welcome!

My big accomplishment for the day was speaking with a new vet. She seems wonderful and well versed in feline diabetes and supportive of home testing. We have an appointment next Saturday to meet her and to get Jack checked out.

Once again....I could not have made it through this week without the help and support of all of you. Maybe you have responded with advice, just said hello, or just read one of my posts and learned something helpful. I know I have learned from other peoples posts and from checking out other spreadsheets. Thanks for a warm welcome to this little family.
(one of my favorite tips i read along the way was to catch the drop of blood on your fingernail if your cat gets squirmy before you can get the meter ready, and just test it off your nail. that has saved me a few times!)

 

Oh good. It will be interesting to see if he will eat during the night and whether that helps to bring his morning number down. If it has 2 settings, you might do one about +6 after the pm shot and then again at +9?

You have come a long way, baby, :RAHCAT and all in one short week.

 

You're doin' great Darlene. I think the first week is one of the hardest when you're brand new to everything and trying to figure out what you're doing. Of course, the vet/vet tech issue with the syringes didn't help anything (crazy!). Jack had some really nice #'s today. I think the curve this weekend will help you see what he's doing early and late and hopefully give some clues to the higher pre shot #'s. Coming off the antibiotics might help as well. Let us know how the curve goes.

 

Welcome!
I am new here to and it looks like are you getting some great numbers
I am not one who can give advice,
but keep up the great work!

Denise and Shakes

 

Sue, the feeder actually has 5 compartments for feedings, so I can definitely set 2 overnight feeds. I figured I might as well get this one because my daughter will be starting school next month and I will most likely lose my tester/feeder while I'm at work, depending on her schedule. Funny story about the feeder...I put it on the floor empty to let the cats check it out, and Tucker went over to it and stuck both front paws in the food well. He looked like he was getting a pedicure and soaking in a foot bath...lol.

Thanks Denise and Holly...Jack did have a good day despite those glaring red numbers. I will be happy to see those go down soon, I hope. Looks like Max is doing great!! Denise, are you finding the PZ working better than the Lantus?

 

Congrats on your first week!!! Time to pat yourself on the back & celebrate!

party_cat drinking24 :dizcat

 

Congrats Darlene and Jack! It does get easier I can assure you. We all have stress in the beginning (and sometimes now) but this board is a gift from the gods laptop_smiley

All the best to you and Jack now and beyond!

cat_pet_icon

 

Thanks to all! The curve is going well so far today, and I was happy to see a PS number in the pink this morning!

 

Darlene it has been a joy welcoming you aboard. You will find a whole new set of things in your life to be delighted by or driven crazy by. a nice set of numbers dancing_cat is enough to make one and all stand up and do the happy dance..
a sorry amps or pmps has been known to throw one into despair (but only in the beginning) angry(2)_cat and there will be days you are just plain :dizcat or even :RAHCAT but it's nice to know we will be together for all of it.
now i'll go look at your dear Jack's SS

 

ok Darlene after a good long look and crazy analyzining of your ss these are my thoughts.
while the drop gets you into that pretty blue color...it is yet a steep and fast drop. not good. better to be a red to low yellow or high blue...in other words i would not raise the dose to acheive a better nadir...or to acheive a better ps. this causes bouncing. i am almost a changed person in the last month or so from being a big shooter into understanding (finally) that more is not necessarily better. your jack is the dka no? can we afford to stick with dose for longer periods of time...let the numbers smooth out and then and only then raise the dose?
i'm not sure if my pzi brain has gone all levemir on me and i no longer understand how pzi works so girls...please feel free to correct me. this is not normal pzi talk but i'd prefer to see average ps numbers and forget the nadir for now...not that we don't want to know it, but we are not aiming for it to drop dramatically.
does this make sense.
i feel the ps numbers will be higher due to that dramatic drop.

 

Congrats on completing first week! Are you checking those ketones regularly? A trace is not to be ignored.
Have a good weekend!

 

I like this curve. So maybe food overnight will lower that amps. That would be great. Some blues, then a yellow after eating - not unexpected.

Not super low numbers, Darlene, but very respectable for one week on insulin with antibiotic on board. It gives us to work with and I think is encouraging. Hope you have taken time to pat yourself on the back for all your hard work.

 

So I wasn't planning to increase from the 1.2 u, but Lori, do you think I should go back to the 1 unit? Yes, Jack was the dka. I haven't been able to catch him in the litter box again for ketones. Maybe that can be my Saturday night goal!

 

not necessarily, but stay with it even if your numbers are not exactly what you'd like. Again I may have my lev hat sewn onto my head now...but would'nt it be best to level out more before increasing for better numbers....and i ask this of the group?

 

Just checked him at +8 and he has bounced back up to 437. UGH!

 

yes, i'm afraid we are stuck in the bouncy mode....
two schools of thought.
the insulin pooped out and numbers went up----------i'm not buying that one
the cat went low enough for liver to say 'huh?' and spit out a bit of glucose into blood stream to 'protect the cat' ----this is why i'm thinking just stick with the dose.
i used to hate this phrase god knows...but it's called 'shooting thru the bounce' or 'liver training' ugggg. hard to say but I do stand corrected for many of my earlier thoughts.

 

hey, just a thought...are you sure you are handling the insulin correctly....the vet was'nt much help with the syringes.....
no shaking,
refrigeration,
no floaties in the insulin
check the expy

 

OK, so I will just stick with those dose for now. Doing all the correct things with the insulin, using the conversion chart for the u100 syringes. I'm hoping now that he's done with the antibiotics that will help too. He did eat a bit differently today too. Ate some at 11:00am then not until about 2pm (just after the +8 test). He had been eating about noon, right around the +6 mark. Trying to figure out the best feeding schedule for him.

 

Well, darn. Wish he had gotten a nice surf....

Yes, I think the food can really play a part - once you figure out his personal patterns.

I would stick with your dose for a few more cycles.

 

So I'm not sure what's going on with my little guy. numbers all over the place today. I checked a +8 reading again today to see if he bounced right back up like he did yesterday, and unfortunately he did. :-(

425 @ AMPS
91 @ +4 (missed +3 test)
173 @ +6
454 @ +8

Kept the dosage the same, 1.2 un. He hasn't seemed as hungry today but did eat (none of the cats are eating as much today for some reason). Haven't been able to catch any urine. Any advice? Still stick with the same dose or try to lower since these big drops aren't good? I'm trying to keep better track of the food and writing down how much I am putting out and at what times to try to get a better feeding schedule. Am I supposed to be limiting intake at this time, or not until he's regulated. I think I read that until regulated, you don't have to be as concerned with limiting intake...is that correct?

 

I think I would try a little lower dose. You are getting a steep drop.

You are right, when they are regulated, feed more.

 

agree, shave the dose a bit.

 

Thanks Sue...do you think drop back to 1 unit, or do I need to go lower, like 0.8?

 

i think a tiny shave at a time would be prudent

 

I would lower the dose, and feed him as much as he wants to eat. I would especially encourage eating in the 1st half of the cycle as that can help moderate the drop.

 

OK, will do. Thanks Lori and Sue

 

One unit and let's see what you get.

 

As far as how much to reduce I think you will need to try things and get data. You could try 1u and if you are still seeing monster drops and a rebound pattern you could try 0.8. Or you could try 0.8 and if after a few cycles (I would expect tonight to be high #s across the board from the rebound) the #s are too high overall, then you could go up to 1u. It's kind of a toss-up - I don't think you are risking hypo with 1u, it's more just the steep drops.

Did I see you had trace ketones at one point? If so you might want to go with the 1u rather than pulling back any further.

Also if your schedule/stress level tolerates early shooting he is the perfect candidate for that. Clear drops, good nadirs, major zoom factor. If you are interested in doing that you might need to pull the dose back a little based on how early you shoot, so post for advice before trying (I'm not an expert, but there are some who have had great success with that). The idea is to head things off before they get to the high #s, that way you can avoid any steep drops, and also keep them in good #s for longer which often helps the zoom settle down. It's a stressful route though, just mentioning it as an option.

 

I'm not too familiar with the shooting early...but I assume you mean giving the PM shot before the 12 hour mark? Then when do you do the next shot?
On weekends I am home, but during the week I leave the house around 7am and get home usually around 5, so Jack is on a 6am & 6pm schedule which works well. My daughter is 19 and has been home checking his blood sugars, but hasn't given the insulin and really isn't comfortable with it now. So I think we need to stay with the 12 hour schedule.

He does seem to have his peaks a little earlier than the 6 hr mark, and then when he goes so high at the +8, then drops a little by +12. I was reading several articles on rebounding and I guess that's what he's doing. I have to tell myself it's only been a week and I need to be patient. But that's the hard part.

 

Yep, that's shooting early. Ideally you do all the shots early, so either TID (shooting every 8 hours/so 3x a day), or something like every +10. Or as needed, where you shoot as soon as they cross your threshold, like when they hit 150 or 200.

It's probably not really needed and sounds like not a good fit for your schedule, so I wouldn't worry about it.

Yeah that's where I was thinking rebound too - that drop from the +8/+9 down to the next +12 is what seems characteristic to me, and of course being that high already by +8.

You are actually seeing some really good #s for this early, so that is awesome!

 

so.... no shooting thru the bounce or liver training here? just wondering since the dka and all.
and please remember i was never a fan of that sort of thing.

 

I'd say we be patient. Jack is just starting his second week of insulin and getting pretty good numbers.

 

Better numbers today so far, not quite as big of a bounce at +8 and +10. I was home sick today and curious about that afternoon jump so figured I'd check it. I tried to keep more food out throughout the afternoon.

 

Those are nice #'s today. Paws crossed for a little less bounce in the PM. So far so good.

 

Not bad at all. What are you sick with? Hope you are better soon!

 

Yeah, I dunno, I may have kind of contradicted myself all over the place. I wouldn't object to early shooting, which I guess would constitute shooting through it. I wouldn't raise the BID dose though to shoot thru it, cuz the drops are steep enough & the nadirs are good, at least some cycles. So dose increase doesn't seem right to me, and other than early shooting that's the only way I see to shoot thru it.

I'd probably lean in the direction of lowering the dose a hair (as done already) and see if easing the drops eases the rebound, since I'm not sure if it's real rebound from steep drops, or panicky liver rebound from the good #s. He's actually done enough riding in good #s I'm not sure liver training is an issue in this case. And I am definitely not a fan of shooting through real rebound, unless you have no other choice.

Ketones are of concern of course with a lowered dose :sad: Today's curve looks a lot nicer though than yesterday's, so I think the move down in dose was the right one. With diligent ketones tests.

 

So here we go again with another crazy, colorful day. I thought we were off to a really good start...but then the roller coaster

336 @ AMPS
98 @ +3
89 @ +4
127 @ +5
140 @ +6
450 @ +8
505 @ PMPS !!!!

I'm not sure if I just stick with 1 un for his shot tonight?


Also looking for some advice to prepare for our visit with the new vet on Saturday. I was asked the question in another post if I would consider switching to a different insulin if needed. I know every cat is different, but are there general guidelines for this? how long do you give an insulin a chance before trying something different? I just want to be prepared in case the vet suggests switching and I should really give this more time, or if it is something I should ask her. Any thoughts are welcome! Thanks!

 

I think people typically try for at least several months before switching insulin. If your vet suggests it, you might ask why so fast? It's always helpful to understand someone's reasoning.
I notice a trace of ketones in your SS a few days ago. Are you still testing? That deserves watching.
I am sure Sue will be around to make dosage suggestions.

 

Haven't been able to catch him in the litter box. Found a puddle in the box last night and I checked it and it was negative. I think it was his (I have 2 other cats). he's the only one that pees enough to leave a little puddle.

Well, I have to take my son to a meeting and need to shoot now, so I will just stick with the 1 unit. Will check back in later!

 

Rather than having to catch him in the litter box, some people will put cat in room with box filled with aquarium gravel ----or I just used some shreds of newspaper---until kitty goes.

 

We had talked about lowering the dose a little - maybe .8 for the next dose. Do you want to try that tomorrow? And I think the feeding is the magic ingredient here. I would offer food after the shot - around +2 to see if you had head off that drop. And again around +6 to see if it will let him surf awhile. And keep up the snacks overnight to help keep that am number down. I really think the food overnight will help.

As far as the insulin change. It is up to you. You have only been on ProZinc a week and you are giving one unit and getting blues and greens. Not too shabby. No, we haven't figured out his patterns enough to know how to get that ps number down and allow him to surf longer. Every cat is different. Some start with PZI and immediately do well - see Holly and Kathyh. Some take a lot of finessing. (See Sue and Samwise's latest lovely numbers after weeks of high numbers.) Nobody can predict how any one cat will do with any one insulin.

Just be aware that neither of the L insulins are magic. Look through the threads on both forums. There are people who have been on the L insulins for months and even years and still have very variable numbers. There are lots of kitties who have high ps numbers and low nadirs. And there are people who are on it for 3 weeks and the cats go off insulin. Who knows? It could be that Jack will not adjust to PZI and will need a different insulin. It is possible that he will have the same issues with any insulin. There is no way to know. You just give it a try until you see no progress and you try something else. As with everything from dosing to feeding to insulin choice, Jack is your cat and and you make the decision based on what you think will work best for him.

 

Today the auto feeder seemed to have gotten stuck, so he went for a longer period without food. I guess my daughter didn't notice it was stuck. Yesterday I was able to keep food out all day, so that may have been the key, like you said, Sue. I will try the lower dose tomorrow, 0.8 and see how that goes.

As far as the insulin, I just wanted to be prepared for my visit to the vet. I really had no idea how long you tried one for before changing, but I figured as in humans you need to give it a little time. I just hate seeing him go from those reds, to greens then right back up again. It must not make him feel very good. In some ways he's his normal self, but in other ways he is not.

I will try testing out the feeder more tonight to make sure it's working ok, and will plan on the lower dose in the morning. Thanks again for your calmness and reassurance. I just feel so helpless in some of this...when I pray for the meter to give me a lower number and up pops 505!

 

I suppose that is a completly normal and rational response to an unprayed for high.
Yes, the sugar dance is a marathon they say...not a sprint. Takes a little time to get things moving in the right direction.
It is possibly a bit early to change insulin but if your at the vet anyway maybe he will give you a script for Levemir (my new favorite) and you don't have to fill it but you'll have it to avoid another vet visit. Some vet's are unfamiliar with the new use of Lev on kitties so you may have to coax him/her.
And Darlene, try to use the 5 P's when evaluating your sweet Jack. Is he Peeing, Pooping, Preening, Playing and Purring? If so your kitty is doing good.
And please remember when you are down about a number...your Jack is getting the 5 star treatment for his disease. Even a hooman bean doesn't get treated as well :lol: He is getting everything he needs....and you are giving it to him. Be good to yourself.
Lori

 

I know it can get so discouraging. It seems like you are trapped by those numbers. Two things that might help. It is better for him to be high for a couple hours than dangerously low for a minute. And don't forget to look at the whole cat. Is he peeing/pooping/playing/preening/purring? And in your case, is he free of ketones?

Remember he doesn't know he is sick. He knows he is getting new yummy food and you are paying lots of attention to him (even though it involves pokes) and there are treats! And you need to give yourself credit. You have learned so much in just one week! You have made changes that are really helping him. N

I have no stock in PZI. You should certainly change if you think it will help Jack or if not changing is going to mess up your relationship with your vet.

I wonder why the auto feeder is sticking? Does the food get caught up in the spaces? Maybe you need to return it for a new one?

 

OK, so first things first...got the auto feeder problem solved! The directions on the inside cover were peeling off and when the feeder tried to turn, it got stuck on the sticker. So I taped the label on and it's working fine now. Wish everything was so easily solved!

I can ask the vet about the Levemir and see what she thinks. I like the idea of having the prescription just in case to save a trip to the vet. And he is doing the 5 P's. He is definitely getting lots of love and attention besides the pokes. The only big difference is that Tucker is not cuddling with much him since he's been to the vet. :-(

I have no preference yet on the insulins, still too new at this! I just wanted a little input from you folks to see what your thoughts were so I could discuss with the vet. I'm certainly not at a point were I can intelligently say "I think _____ will work better." I do like the reminder though that being high is better than being low. I don't know if we are checking too frequently now and just looking at the numbers too much...I don't want to become obsessed with this! I have a big certification test to take on Friday and I'm stressing out about everything. So I will take a deep breath, fill the feeder and try to get some sleep! Thank you all again for your support.

(just to make you laugh...I am sitting here typing and was looking over at Jack who was grooming himself in his little cat bed. I stopped typing to look at him and he was cleaning his butt, and then I started typing again. My daughter said..."what are you doing? telling everyone he's cleaning his butt now?? do you have to report on everything he does??) (of course this was after I was hovering outside the litter box trying to catch Jack peeing...but he was facing the wrong way and i couldn't get any)

 

Hey Darlene, how old is your very observant daughter? I have 3 daughters and got a hearty laugh out of a joke I just heard:

If a mother is walking in the forest and her daughter is not there to hear her talking, is she still wrong? :mrgreen:

 

ROTFL!!!!!!!!!!!!!!!!!!! Reality check, I guess we are a little bit off the deep end here at times. B/c of course YES we do need to know that he is cleaning his butt, that's a good sign he is taking care of kitty business successfully!

 

LOL...very funny Judy! I just told her that one and she laughed. She is 19 and has been a huge help in getting Jack's blood sugars during the day when I am at work. THat's why I have been able to get so many readings right now.

Reality check indeed, Joanna! Like I said before...I have definitely fallen into "crazy cat lady" status now! But that's ok, they are worth it. And she can laugh at me all she wants...she's just as crazy as I am, though she doesn't see it yet....

 

That last bit is so true. I prefer to not see how crazy I am ;-) (but I know it deep down).

 

Much better numbers today!!!

319 @ AMPS .8 u given
147 @ +6
174 @ +8
350 @ PMPS .8 u given

Had food out all day, ate well. Mommy is happy today! Yeah!!

 

This looks very nice, Darlene. Wish we understood more why this happens. It's like it takes a while for their body to start working with the insulin - particularly the overnight cycle and the morning ps.

 

Good job. Do you think you could start a new thread tomorrow? This is getting kind of long. Ideally, you would have a new thread for each day, starting with the date, the name of the cat, and the AMPS. Makes things easier to follow. Thanks!

 

Thanks for the tip Judy. I wasn't sure when to start new threads and didn't want to have too many going. but this one is too long now!

And Sue...looks like you were right about food being a key here. I hope we can keep up the good numbers.