3/14 Bonk PMPS Hi?

Good morning Lantus Land! Here is yesterdays condo:

viewtopic.php?f=9&t=115361

A much better experience this morning compared to last night. One little Mew when I gave him his injections. He is still eating well (too well), and I saw him hop up in a window he hasn't gone in for a while, so that was good.

His numbers are slowly creeping down each morning, but not as nearly as fast as I'd like them to. (Yes I know Chris, Blue Patience Pants! )

Thanks everyone for the suggestions on giving the injections last night. I think some of those ideas will help out. Never even thought to consider the directions of the bevel of the needle before. I'll practice fur rolling on Faolan first, as he isn't getting injections, and won't suspect anything bad. He'll just think I'm being annoying, and will probably turn it around on me as play. :lol:

Anyway, need to get back to work, just thought I'd check in. More later.

Re: 3/14 Bonk AMPS 462 +8 416

After eating everything in sight yesterday, today he doesn't feel like eating much at all. I just don't get it. He is otherwise doing fine, numbers are still too high though, but better than yesterday. Looks like tomorrow night we will be due for another dose increase.

Re: 3/14 Bonk AMPS 462 +8 416

I am glad the shot was less stressful this time. I put Lovey's freeze dried chicken pieces on the floor and then shoot her.
It is a good sign that Bonk jumped out to his window spot. Hopefully he will eat more tomorrow.

Re: 3/14 Bonk AMPS 462 +8 416

Sorry you had such trouble with Bonk's shot yesterday. I'm glad this morning was better. I can remember when Furball was first diagnosed how stressed out I would get at shot and test time if things didn't go right. That just made Furball more stressed out. They can sense our stress. I know it's not easy, but try to be calm during shot time so Bonk doesn't pick up on your stress. Just stop and take a few deep breaths. I hope Bonk will eat more for you later.

Re: 3/14 Bonk AMPS 462 +8 416

Brian --

When numbers are staying in the above 400 range, you can consider increasing the dose every 2 days/4 cycles. I'd also consider an increase of 0.5u as long as you'll be around to monitor. You can still hold the dose for 3 days but unless you see the nadirs coming down, I'd encourage you to think about increasing by 0.5u.

The reference for this comes from the protocol used by the German counterpart of our Lantus Board.

Phase 2: Increasing the dose
Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl.

Click to expand...

Re: 3/14 Bonk AMPS 462 +8 416

Thanks everyone, he is eating much better tonight. I just had to find the right food. Seems he wanted Beef, not fish, tonight. And it had to be Fancy Feast, not the Weruva. My being home from work probably also had an influence on his eating. I come home, he starts eating. I guess all if forgiven from last nights events.

Thanks Catherine, yes, I think a food distraction could help. But he only eats when he wants to eat. Which probably won't be at shot time. :smile:

Thanks Carla. Staying calm isn't always easy. The odd part is, I was doing better with it when I first started. Now I'm a couple weeks into it, and we both seem to be getting more stressed out over it. We will figure out a pattern.

Sienne, I was not aware of that. From the protocol published on this site, I thought the minimum was 3 days. I think I might go with the 2 days then, only because I haven't seen a drop below 400 since I've had him eating again. Thanks for the link, great information on that site.

Re: 3/14 Bonk AMPS 462 +8 416

What length of syringe are you using? Some people find short works better while others like longer ones dpeending on the cats reaction. Also you don't use alchohol swabs or anything right? Could also try a different spot on his body to inject , away from the spine.. Along the flank etc.

Re: 3/14 Bonk AMPS 462 +8 416

What my vet prescribed are short 30g syringes. And no, no alcohol swabs. I can imagine that would sting and not make a happy cat! I try to change spots on every injection. I think the big problem was I was being too picky on the spot. I kept pinching different spots until I tented his fur the way I wanted. So first I annoy him, then I poke him with the needle, and it just escalated from there. No, I won't let it go that far again. Thanks Wendy.

Okay, I don't know what could have happened tonight. At +8 Bonk was at 416, but at PMPS he was off the scale again. I can't possibly think of what he could have eaten in that time other than about one can of Fancy Feast Classics that I gave him. I suppose there could have been some dry food someplace I missed, but I don't know where. (If there is some contraband someplace, I'm sure he will find it!) I can't figure any other way his number could have shot up like that. Seems like an odd time for a bounce.

Other than that, I did start him on the higher dosage tonight, 2.75 units.

More likely it is just that he was past his nadir at +8 rather than it being something he ate to cause the HI. It's definitely not unusual to see a kitty go up once you pass the halfway point in a cycle.

Yep, patience is challenging when it comes to FD, but unfortunately it's necessary. You guys are doing great...you WILL get "there"!

i always did somewhere between the scruff and about 5" back along punkin's shoulders. He had a strong preference for one side and didn't object there, but he did on the other side.

Are you withholding food after about +4ish? When you say he might not be hungry at shot time, i'm wondering if he's eating later in the cycle. Some cats can get away with grazing but many have better cycles if you don't feed after the insulin has peaked, which is the low point or nadir in the cycle.

I fed punkin between preshot and +3 and then only gave a very small 1/2" cube of boiled chicken as a treat after poking between then and the next shot. He was ALWAYS ready to eat, although he had acromegaly, which makes them very hungry. we set down the bowl and as soon as he started eating, gave the shot.

The reference Sienne gave you is primarily used when a cat is solid high (over 300's). Because you think he may have been getting into the dry food, and you've now removed his access, i've been thinking his numbers may change (drop) dramatically. So just be aware that his insulin needs can go down significantly with the dry food gone. I do agree that you want him out of these high numbers! Let's hope that a dose increase will get him there.

No advice from me, Brian, But just wanted to offer some encouragement. I know this can be frustrating, and in the age of instant gratification, it's hard not to expect quick results. But FD is like that - I'm sure you've heard "it's a marathon, not a sprint" several times already, but it is so true. Just hang in there and keep plugging away. It will get better - I promise!

Hey Brian!

Sorry..had a busy day and just now dropping in to check on you and Bonk

I'm glad they posted the more aggressive dosing for you. Bonk is being a stubborn little snot, isn't he? :lol:

We occasionally do "fast track" a cat like Bonk who is so stubbornly stuck in those high numbers. We want to see him come down almost as much as you do! Once we do start to see some movement, we'd want to go back to holding the dose for at least 6 cycles, but we need to get his attention first.

Good ideas on the feeding too. I try not to feed China much after +6 because the insulin is starting to wane, so you might try getting most of Bonk's food in before then and see if it helps...with his numbers as well as his appetite!

Keep up the great work. Trust me, at some point it'll start to show some positive results!

Amy and Julie made some good points. The other consideration is that Bonk is just beginning to see some pink and yellow numbers scattered on his SS. His body is very used to sitting in reds or higher. When a kitty's body has been sitting in a particular number range for a while, their body "adjusts" to those numbers and treats that range as a new "normal." This is referred to as glucose toxicity. It's why with the TR protocol the doses are not held for an overly long period of time and why the protocol is viewed by some as aggressive.

Re. the protocol I linked from the German Lantus forum, it's actually in the links in the TR protocol sticky. The German forum is where the TR protocol originated. The moderator of that forum is Kirsten Roomp (the Roomp of Roomp & Rand who published the TR research paper in 2009). I tend to find the modifications we use here a little more straightforward. Between what we use and the German forum's info, we have a fair amount of flexibility to adjust for the needs of any particular kitty.