Java and Lois, new here, diagnosed Oct., need better MO

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Lois and Java, Jan 25, 2017.

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  1. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    From Intro page:
    My 20 year old DSH neutered male Java was diagnosed in early Oct. I have four months of data on notebook paper - date, time, BG, dose, notes, and vitamins. Java ended up in the vet emergency room for day and half. with a BG of 36 after the first two days of his vet-prescribed insulin regimen back in Oct. Vet prescribed 2 units bid, and what a crash.

    I've been tracking everything ever since, but I don't feel like I have a handle on any of it, not really. I was at his vet for the 4th or 5th time yesterday asking for help. I came home not feeling like I'd gotten any and started Googling. I could kick myself for not doing this back in Oct. because I found this website right away.

    I'm trying to work with your spreadsheet template*, since I have 4 months of data. I didn't know that I should do a proper glucose curve, though I probably could produce several from historical data, and am tracking Java closely today. He's very reactive, too many spikes high, and drops low, possibly/probably because I'm only dosing when he goes high? I look forward to learning more here and getting a better handle on it. My name's Lois.

    *does anyone ever just convert the +1, +2 etc. in concrete time? 8 AM, 9 AM, 10 AM etc?

    So! I've been doing testing for a proper BG curve since 4pm yesterday. Where to go to plot it on a computer? Excel? Google docs? Shodor.org? Or just do it on a piece of notepaper and photograph it? Word? Retired paralegal here, mathy stuff not my strong suit, though I'm proficient on Excel.

    Insulin: ProZinc
    Meter: Henry Schein vet meter, measured in mg/dL
    Soon to become a backup. AccuTrack ordered, and should arrive in 3-7 days.
    Feeding: free feed round the clock. Shares feeding area with healthy 5-year old.
    Diet: Fancy Feast classic. Home cooked plain chicken. Eliminated dry food after diagnosis, tried adding back in after 4-6 weeks with bad results. Cut-up dehydrated chicken breasts available to provide alternative to dry kibble, for which he begs when feeling spry (he has to jump up on the dryer to do so, and he does).
    Treats: for chronic dry stool, Feline Greenies Smartbites Hairball control, approx 15 per day. Definitely spikes glucose, definitely kitty crack. Might have to eliminate?

    He's an old man, 20+, still enjoying himself inside and outside (makes his rounds every morning), eats well, if a bit picky sometimes. I worry about his weight, which seems to be holding steady. He'd lost a few ounces from Oct. at his last vet appt. about 3 weeks ago. It's the main reason I haven't picked up food - he's been a free feeder his whole life. But I'll do it if it helps.

    We've gone through three more hypoglycemic episodes since the first one, very scary. Handled at home pretty quickly, he will eat, he will come get me if he doesn't feel well, if I don't catch. I've been testing in the AM, and throughout the day when home, and giving insulin any time his BG is over 250. He's really sensitive to the insulin most of the time, and sometimes not. I need to sit down and do some curves from last night/today's data, plus I have enough data from other days, maybe not every 2 hours, but lots of testing. My MO is flawed, it needs to work better for him, and for me - I can't be here to test him every few hours every day, and I like to travel, and need something my fabulous and responsible house/pet-sitter can handle.

    I've been getting complete blood panels annually for 4-5 years, because of his age. He shows in the early stages of renal failure, although the values had barely changed annually for the past several years. I did sub-c fluids about once every 2-3-4 weeks for awhile, but stopped with vet's okay since it didn't seem to matter. Gave all the Ringers to the vet. He's always been a big water drinker.
     
    Last edited: Jan 25, 2017
    Reason for edit: edit to add.
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  2. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome.
    It is good that yo are home testing
    Most of us here test our cat's blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
    Have the BG information in the SS allows others here to see what is going one so we can make suggestions.

    One concern I have with free feeding is that you have another cat and could it be that Java is not eating the same about of food during each feeding cycle. If Java eats less then that could explain the low BGs
     
  3. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Thanks for the extra info, Lois. Now more questions and comments:

    You can lessen the burden of doing a curve by testing every 2 hours starting with the AM test and ending with the PM test 12 hours later. No need to plot a graph if you use our spreadsheet:
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
    There's help available to set it up if needed.

    Some cats are very reactive ("bouncy" as we call them - mine is a prime example) but with careful, systematic dosing over time some of this can be smoothed out. Yes, you absolutely must be giving insulin regularly at 12 hour intervals if you have any hope of getting Java regulated or, even better, into remission.

    No, we use these time designations because the members here are all over the globe in different time zones. Using actual clock time would be extremely confusing.

    I'm not familiar with this meter. The pet meter mentioned here is the AlphaTrak. It's main selling point is that it gives BG readings that are close to what the vet would measure. The test strips are extremely expensive which is why most people use a human meter.

    Friskies and Fancy Feast pates are fine for diabetic cats, as are plain cooked chicken and freeze dried meat treats. You're giving quite a few high carb treats each day. If you eliminate them that would be best. There are other things you can use for hard stools.

    He needs insulin at 12 hour intervals, even if the dose is tiny. There are procedures for weaning a cat off insulin if they've proven they're ready to go OTJ ("off the juice"). You don't know if Java is there yet until you test/dose/log data in a systematic way.

    No need: AM/PM before shot then one other time mid day or before bed. More testing on weekends if needed.

    It's doable once you have a system in place.
     
  4. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Thank you.
    I begin my 24 hour glucose curve at 4 p.m. yesterday. The odd time is because test strips didn't arrive as scheduled, and I ran out, argh, and 4 pm is when I got them.

    I'm an hour away from 24 hours, and he's gone up to 381. Dose now, yes? Should I have done at 328 - 2 hrs ago?
     

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  5. Pati

    Pati Member

    Joined:
    Nov 2, 2016
    Hi Lois. Welcome. ProZinc is dosed every twelve hours so for example my cat is dosed at 6am and 6pm. How much you dose is based on the BG reading before each injection (AMPS - AM preshot and PMPS) and by how low that dose is dropping the BG midway through the cycle. If you go to the ProZinc forum there are some "stickies" at the top of the forum that have a lot of information.
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    OK. Just looked at your graph. I see the BGs but no indication of when the insulin was administered. At 4 PM yesterday? When was the next dose? At 4 AM this morning? If you dosed 1 unit at 4 PM and 4 AM then the curve is showing quite a large drop between dose and nadir (lowest BG point). That can be an indicator that the dose is slightly high. However, until you have more data over several days at this dose with the insulin being given every 12 hours, it's hard to be sure.
     
  7. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    The units are in brackets at the bottom. I gave him 1 unit at 4 pm yesterday, and 2/3 unit at 3:45 am today. I gave him 1/2 at 3:15 pm because I had to leave for about 1.5 hours.

    I've not been dosing BID so I'll need to work this schedule around to 8 am, pm somehow.

    I thought I'd give him a break and test him every 4 hours the rest of tonight and middle of the night. Sound okay?
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I think you can stop testing for now. I understand your dosing. Based on that small bit of data, your graph is showing that your kitty's BG has responded properly to the two different doses - ie., the nadir value was higher when you gave 2/3 u than when you gave 1 u. Are you using U40 syringes with half unit marks? How did you measure 2/3 unit?

    I recommend that you set up a testing/dosing schedule that you can stick too as much as possible. I also recommend that you pick a reasonable dose and stick to it for a few days, test AM/PM before injecting plus one other test midcycle or before bed. If you can get U40 syringes with half unit marks it'll be much easier to do dose fractions.
     
  9. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    I guess my mistake is not sticking with one unit? At 6:45 he's at 254. And I have to leave cuz I have theater tickets.
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Maybe 1 u is the good dose right now, maybe not. You need to gather data systematically to know for sure. Start with 1 u BID for a few days.
     
  11. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Hi, thank you for your comments. Since starting to post, I've continued taking very regular readings and graphing them. I also took some historical data and graphed it. They're pretty crude hand-drawn things. I took all the day that to my vet yesterday and we took a look. His observation is that Java is very reactive to insulin, a little bit causes a big drop. But then it goes back up. I'm attaching photos of my charts.
    This is 1/25 to present 1/28.
     

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    Last edited: Jan 27, 2017
    Reason for edit: Note chart dates
  12. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    2 of 4 -- 1/22 and 1/23
     

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    Last edited: Jan 27, 2017
  13. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    My vet's suggestion is, continue using the ProZinc, starting today, dose one unit every 8 hours, and track his BG every 3 to 4 hours. Do that all weekend, including today Friday. Thoughts? Feedback? I appreciate having experienced eyeballs looking at this!

    My constant worry is HG of course. Plus he seems to be getting more hind leg neuropathy. He still begging for dry food and treats, which I'm not giving him. That's a really hard one for me, because it really spikes his BG, but boy does he ever want it. When he was first diagnosed, I eliminated all dry food, and he was doing great without insulin, or having it very rarely. Until I let him start with one sixth cup of MD Science Diet. It's been difficult ever since. I'm not giving him the dry food regularly, maybe that's the problem? Curious to know what you think although my main concern is whether or not every 8 hours is good idea or not.
     
    Last edited: Jan 27, 2017
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  14. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    I'm still reading more here. I am wondering, because I have food down 24 hours a day, if I should instead start over as if new, taking food up 2 hours before a dose, and doing the PIZ every 12 hours today and this weekend instead of every 3 hours.

    Among other things, this would enable me to use your spreadsheet. I have too much variation right now to adapt my historical data to your spreadsheet without modifying the SS.

    Should I be posting in the prozinc thread?
     
  15. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    You are getting good reductions with the ProZinc. However, you are getting very large swings.
    How much (compared with total for the one shot cycle) food does Java eat right away after the shot?
    Maybe changing to Lantus or Levemir will help reduce the swings
     
  16. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Sorry I didn't notice earlier that two of us had gone sideways. Here they are again, right side up.
     

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  17. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    I'm really not sure. Maybe this is my problem with the swings, not having better regulation on his food? He grazes on his own, and if I am testing him, it's near the kitchen/their food, so he will eat after testing, sometimes right before it while I'm getting the kit together. My guess would be can and a half of Fancy Feast classic spread out over a day, plus cut up dehydrated chicken breasts from Trader Joe's now and then.
     
    Last edited: Jan 27, 2017
    Reason for edit: Fix typos
  18. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    My immediate concern is, do I go forward with Fri, Sat, Sun, with 3 shots of one unit per day, or should I back off that and do one shot every 12 hours? If I do the 8-hour plan, he will be due for a shot in about 1.5 hours.

    He got a shot at 7:30 am; his BG was a whopping 466. His BG at 12:30 pm was 156.

    I think I'm answering this myself, unless it really Skyrocketed in the next hour and a half, I wouldn't want to give him another unit because he likely would go into hypoglycemia.
     
  19. Zoey & Carol

    Zoey & Carol Member

    Joined:
    Jan 4, 2015
    I've been reading your thread and since no one has answered yet, I'll give you my 2 cents. Zoey has been on ProZinc for 2 years, so I have some experience. I would definitely not give a shot if his BG hasn't gone up a lot.
     
  20. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    The only dry food that is ok for diabetic cats are Evo cat and kitten in the purple bag and my favorite Young Again Zero carb food available at Youngagainpetfood.com.

    Unregulated cats are often hungry all the time. You can give several smaller meals of ff throughout the day, but NO FOOD two hours before the preshot test.

    Instead of the hairball treats which are super high carb, try adding a bit of plain pumpkin to his food.

    Every 8 hours is not a good idea. We will help you find the right dose for every 12 hours.

    The spreadsheet is great... Download Google Sheets to get going with it. There are a few ss experts on here that can set it up for you if you are really struggling with it.
     
  21. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Thank you so much for your comments. I feel very emotional about it all suddenly, I can see his mortality looming as the slight drag in his hind legs gets a little worse. I'm so grateful for other people to talk to, so happy-crying relieved for your knowledge. I have felt that I'm doing it all wrong and terrified that what I'm doing is making things worse for Java, not better, even with regular consultations with the vet.

    His BG was 383 at 4 pm. He just ate a bunch - I have to get used to quanifying this for myself, about 1/2 - 2/3 can FFC -- pulling up dishes now and will test him at 8, just 30 minutes behind 12 hrs. From last shot.
     
  22. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Is he getting vitamin b 12 for the neuropathy? You are doing great.... You have lots of people here to help you.
     
  23. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Yes, Jarrow B-Right, B vitamins, methylcolbamine + Pantethine+P-5-P, info obtained from Tanya's kidney cat website, excellent website. Someone was curious about my meter; Henry Schein is a medical, dental, and vet supply company. The strips are close to $1 per strip, come in packets of 50. The Henry Schein salesman gave a starter pack (including 25 strips) to my vet, who gave it to me in turn. I ordered an AlphaTrak earlier this week, so the Henry Schein will be back up. I'll look into the human type if (no, when!) Java is stabilized.

    I just ordered a bag of Young Again Mature food. He craves kibble, and also the fiber treats I mentioned above (Greenies hairball relief). I got some pumpkin and tried it today, he ate a little bit. I don't want to let him get constipated for days. Besides the Greenies, pumpkin, there are tubes of Cat Lax and similar. Is there anything else for cat constipation?

    I'm feeling less anxious. His reading at 8 was 385, and I tested him, fed him, and waited a bit before giving him 1 unit. He also seems better than he did during the day, not sure if it's the prism of my mood or not. Next to do: start using the spreadsheet. I couldn't use it with the irregular schedule I'd been on, not without re-doing it to add columns, which would necessitate re-doing the programming for the color coding - super nice feature. But now that I'm starting a twice a day schedule, it'll work great. Thanks for your feedback and help, very much.
     
    Last edited: Jan 27, 2017
    Reason for edit: a few rewrites
  24. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I'm so glad you're feeling better. Knowing you aren't alone makes this journey easier. I'm sure your cat picked up on it.

    Cats can also be given Miralax for constipation but I don't know the dosage. The pumkin had worked for several of my cats in the past... And I know it doesn't spike bg. Try the pumkin, add a little extra water to the wet food and see how he does over the next few days. If it's not enough than look into the Miralax. I also find my cats drink more since I bought a few cat drinking fountains. Santa brought it for Christmas. Heehee


    I'm glad you are giving young again a try.... It really is fantastic. Did you get the mature one? It's low in phosphorus too for kidney health.

    I'm glad you are going to try the spreadsheet....it really makes it easy for us, and you, too assess what the numbers are doing in a glance.

    If you could also set up a signature with info like date diagnosed, food you're feeding, and type of insulin that would be great.
     
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  25. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    testing signature and spreadsheet.
     
  26. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Do I keep adding to "my thread" now as I have questions? I have more questions and some worries.
    1. I'm worried that Java is constipated. The greenies hairball relief treats really helped with his hard stools. He comes inside to use the litter box even if he's been outside for his morning rounds, and he hasn't had a good poop in a couple of days. He had some pellets yesterday and this morning, there was a dried poop elsewhere that had clung to his butt and dropped off. I gave in to my worry yesterday and gave him 7, but it's actually a half measure, a dose being 14, so that was dumb of me now I see.
    2 &3. I thought he was holding his own with weight, but now he's not, he's losing weight, and the hind leg neuropathy seems worse. I sprinkle a little bit of the Jarrow B on nearly every bowl of food, but should I try the injectable kind? I gave him some MD last night also. He wasn't eating after testing at 8:30, and I knew he'd eat that.
    Then 4, this morning, he was at 410 at 6 AM, but he'd had a shot at 9:15 PM, so I took up his food, went back to sleep, woke up later than usual, tested at 450 at 10 AM and waited some more for him to eat, so he got a shot at 10:45. Could I have given him 1 unit at 6 AM?
     
  27. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It's great that you've set up the spreadsheet and put in all the data you've collected so far. If I understand it correctly, on 01/23, 01/24, and 01/28 you gave only one dose a day. On 01/27 you gave a different dose in the AM and PM even though the BG numbers preceding the dose were in the same range.

    Most cats do best with a very consistent insulin dosing routine, ie., two doses a day 12 hours apart (or close to that) with the same dose given AM and PM. After you've collected a large body of data on your cat's responses to a dosing regimen it's possible to deviate from this slightly but you're not there yet. Your SS shows considerable variation in dose timing and wildly fluctuating BG numbers. It's difficult to tell if a 1 unit dose is too high or not.

    I suggest the following:
    1. choose two times 12 hours apart that you know you'll be available at home to give your kitty his insulin and stick to those times (plus or minus 0.5 hour is OK)
    2. choose a safe dose and stick to it for 3 days to evaluate its effect. I suggest a 1 unit dose for now if you can monitor him for the next 3 days
    3. test prior to feeding and injecting (no food for at least 2 hours before) in the AM and PM
    4. test in the mid section of the 12 hour cycle - eg. at +4, +6 and +8 to determine how low this dose takes him
    5. feed only low carb wet food and perhaps try plain canned pumpkin (not the pie mix) for his constipation - a teaspoon added to a wet food meal
    6. feed a larger breakfast, small lunch, larger supper and smaller bed time snack.
    All these suggestions are aimed at structuring your routine so that insulin dosing can be figured out without a myriad of other confounding factors. Are you willing to try this?
     
    Last edited: Jan 29, 2017
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  28. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Dosing every 8 hours is rarely used because it's an unsustainable schedule for most people. it also requires a lot of extra testing to be sure the dose is safe to give. It's better to try to make every 12 hour dosing work for you.
     
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  29. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Pumkin or a 1/4 teaspoon of Miralax could help the constipation... And make sure he's drinking enough.

    Good job getting the ss and signature going!
     
  30. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Java drinks a lot of water already, he always has, though he increases with high BG.
    How do you dose a cat with Miralax?
    I gave him plain pumpkin in food the afternoon of the 28th.
    And gave him as much CatLax as I could - maybe a half inch - at 6 AM today.
    My error in the spreadsheet, now corrected. He had insulin AM and PM but not at the same time, because I was holding off because he didn't eat much in the AM.
    Will need to institute feeding hours. I tend to follow him around with bowls saying, Eat! Eat! and he doesn't always.
     
  31. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I think most people just mix the miralax in with the food.
    for the pumkin you can put a teaspoon in each meal.
     
  32. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    1. >> choose two times 12 hours apart that you know you'll be available at home to give your kitty his insulin and stick to those times (plus or minus 0.5 hour is OK)
    This AM, BG at 410 at 6 AM. Should I have dosed him then, because it was high, and close enough to 7-7:30 AM, and he'd eaten something? Instead of waiting until 10 AM?

    How much does he need to eat? Yes, I will have to change feeding patterns, this isn't working, the time keeps creeping as I wait for him to be hungry, then wait 30-45 minutes after he's eaten to shoot.

    Today, starting BG at 450 at 10 AM. 1 unit at 10:45 (waiting for eating, then 30-45 minutes). BG at 12:30 was 349. Right now, 4:40 pm, 159. That's interesting, I thought it would continue to go up. He just ate some pumpkin and FF, drank water, back to nap some more. I'm off my goal of 7:30-8:00 AM and PM, so at what point do I go back?
     
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    If you tested at 6 AM and there was no food in him for at least 2 hours beforehand, then that is a valid test number to decide on dose. You should then have fed him some low carb wet food - doesn't have to be a large meal - and injected his insulin right then while he's eating or immediately after he finished. Identical routine at 6 PM (no food for at least 2 hours before that test as well).

    A small meal is sufficient with ProZinc or PZI because it's slower in onset than some of the shorter-acting insulin. Something like 1/4 or 1/2 can the size of a Fancy Feast can would work.

    Should have happened at or shortly after meal given right after 6 AM test.

    Why not take a bit of liberty just for today and wait until 7:30 - 8:00 PM to test. Don't let him eat anything beyond 5:30 PM. Tomorrow morning you can test at 7:30 - 8:00 AM and you'll have established your schedule going forward.

    You have to get a structured routine going and stick with it in order to make good dosing decisions. If he likes to graze on low carb food through the day, that's fine. Just take all food away for the 2 hours prior to AM and PM tests.

    So, a sample schedule might look like:
    • 7:30 AM - test BG (no food 2 hours before)
    • feed a small meal
    • inject insulin while eating or right after
    __________________________________________
    • maybe try structured meal time mid day to train better eating habits
    • allow to graze if he insists
    • try to get a mid day BG test or two if you can
    __________________________________________
    • 7:30 PM - test BG (no food 2 hours before)
    • feed a small meal
    • inject insulin while eating or right after.
    Many people use automated pet feeders for overnight feeding of snacks. They allow food intake overnight and you can set timing so there's no food available for 2 hours before the AM test.
     
    Last edited: Jan 29, 2017
  34. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Thanks! I tested at 8, BG 191, which I think is too low for him to have a dose. He ate about tablespoon of food. I'm guessing pull food up again and test again at 9:30 to 10?

    I'm glad to hear I don't have to wait so long after he eats food to give him an injection. It was in the faQ's to wait 30 to 45 minutes after eating.
     
  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I'm confused. You have a bunch of data on your SS for today, January 30/17 and it's only AM. Is there a mistake on the date? I see you're in California so it's only around 6 AM your time right now. When are you going to begin the 7:30 AM and 7:30 PM dosing schedule? I'm willing to help as much as I can but it would be easier if you had more of a structured system in place.

    Re waiting 30 to 45 minutes to feed: that's for users of fast acting insulins like Novolin, Vetsulin, etc. PZI is not one of those.
     
  36. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Too low to have a dose when?
     
  37. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Hungry cats woke me up, 6:40 here. I pulled up food at 4:45 am, about 2 hrs ago. His Bg was 137 then at 4:45 am, it was 125 at midnight.. Yes I must have filled out wrong lines going to look on laptop bigger screen.
     
  38. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    It would be good for example if you could put how many hours after each test or before and after feeding cats. I saw that you do that in your spreadsheet but it would be easier if you put that info in your posts as well. I get it since I am in the US but was thinking of our international members.:)
     
  39. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I was off by one day all along I guess. 6 am to 5 PM is on AM side; 1 PM to 5 AM is on the PM side. I tested Java at 4:45 AM, he was 137. It's now 7 AM, I test him again.
     
  40. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    I meant putting in hours since shot,
    +1, +2, +3 instead of actual clock times.
     
  41. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I saw that the SS doesn't assign hours to the +1, +2, hours, and found it too big a task to tackle when starting with historical data before I was trying twice a day only. Okay, heat on, more clothes on, let me test the hungry boy.

    227 at 7 am. I would guess 1/2 a unit?
     
  42. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    You have to do what works best for you.
    The reason the SS doesn't assign hours is because members are all over the world and have different clock times where they are.
     
  43. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Try 0.5 u and enter both that preshot BG and the dose on your SS. I think Lisa has explained the +1, +2, etc. time designations we use. Feed now and inject as he eats or right after. I suggest testing at +2, +4, +6, +8 today to see how that dose is working.
     
    Lisa and Smoky likes this.
  44. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    >> I meant putting in hours since shot,
    +1, +2, +3 instead of actual clock times.

    I get that I'll have to start doing that to conform to the norm here, though I'm obviously finding it hard to do (and don't think it makes sense to not use actual hours of the day - it's just like time zones, everyone has a 7 AM whether you call it +1 or something else).
    I'm pretty new here and I have four months of data that's only date/time/BG/units/notes -- I wasn't trying to stick to 1 shot in AM, 1 shot in PM until a few days ago. I'm transcribing notes from paper to this spreadsheet, and I think the +1 system will work better if it's the only record I keep, instead of going back and forth. I'm trying to get with it here, I'm sorry.

    I think I should feed these hungry cats. Java had 1/2 unit of insulin at 10:45 PM, not yet 12 hours ago.
     
  45. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    No need to apologize Lois, we were all new here at one time.:) I've not been here that long yet, just a month before you. There is a lot to learn and it takes time to catch on and get everything going. It's great that you are home testing Java so soon. It took me over a month to really start to test on a regular basis. You are doing an outstanding job taking care of your boy.:cat:
     
  46. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I'm going to start a new section on SS with the +1 and see how that goes.
    Java's been tested 45 times since the afternoon of 1/24, as I've gone about making curves and trying to get into a 1 AM, 1 PM shot schedule. He's a very tolerant cat!
    In all sincerity, how would someone keep track of that using just the +1 system? I know I need to know that I started at 7:30 AM, as I go about my day.
    Anyway, the good news is, look at that! Lots of blues and yellows on the spreadsheet! I am thrilled with the spreadsheet, it's a terrific tool. (I just need times is all, but I'll try with the +1 and see how it goes.)
     
  47. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Oops, I think we crossed.
    Yeah, my vet sent me home with insulin and needles after diagnosis, on a Thursday afternoon, and his recommendation to give him 2 units BID nearly killed Java. I took Java to the vet ER around 11 pm the day after, Friday, when he started walking around in circles, stumbling. OMG so scary. I had a test kit by Monday, that my vet gave me, but ever since that day, I never tried to stick to a 1 AM/ 1 PM shot, which was a mistake. I went to the vet with all my paperwork 4 or 5 times asking for help, more guidance, and he didn't pick up on the lack of 1 AM, 1 PM and obviously I didn't either. And with all my data, I'd never done an actual curve until the ones I posted above.

    I've stuck Java so much, last night I had a flashlight under his ear, and it looks bruised, he's been stuck so much in one area. I'm not trying to torture him, it's the only place on either either where I get a good drop right away. I need to try harder in other places. Don't have a microwave, will have to find an alternative to the rice sock.
     
  48. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    Try filling an old medicine bottle with hot water and using that to warm up his ear.
    You don't really need to test him every two hours every day. That's usually just done on days you would do a curve for 12 hours. I did one on Smoky about once a week when I started, now I do one every two weeks.
     
  49. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sep 6, 2016
    If you want to you could start another thread asking about home testing tips and how to prevent and treat ear bruising. The links in FAQ's helped me out a lot when I first started. My vet also gave my cat a high dose to start with, it turned out to be far too much. I'm glad I found this site when I did and have since changed vets. My old vets solution was to just keep giving him higher doses of insulin.
     
  50. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I feel bad that you were sent home with so little direction from your vet. Unfortunately it's a common story here. What we do here is often different from what the vet might say but it's tried and true and geared to getting a cat regulated if possible but keeping him/her safe above all.

    I think you'll get the hang of the +1, +2 time designations as you use them. It's quite adaptable too. So - if you dose at 7:30 AM, say, and then do a BG test at 10:30 AM, you'd enter the result in the +3 cell on the SS because that test happened 3 hours after the dose. If you test at 10:45 AM you can enter it in the cell as "x" BG at +3.25 and the cell will enlarge to accomodate the extra text. Then you should go to the paint can in the tool bar at the top of the SS to colour in the cell according to the range that BG value fits in.

    Aside from people here on the forum being all over the globe and giving actual clock times creating confusion, we look at a dose's action profile based on time after the dose was given. For example, we might expect to see the dose onset at two hours after administration (entered under +2 on the SS) in some cats and we look to see whether nadir has been reached about 6 hours after (+6 on the SS). All of this would be harder to understand at a glance if we were reading clock times on your SS and having to say, "Hmm ... let's see ... dose was given at 7:30 AM and the BG was tested at 12:30 PM, so that's 5 hours after ..."
     
    Lisa and Smoky likes this.
  51. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I suggest you post on the ProZinc/PZI forum for insulin-specific advice. You can always post on this main forum for general questions.
     
  52. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Looked at your SS just now and I see a BG of 106 at +3 ie., 3 hours after his dose of 0.5 u. That's a big drop from the pre shot BG value. I need to be absolutely sure that the data you entered is as I understand it. If it is, then it's important to do more tests if you're at home. It's about 2:30 PM your time right now. Did you give insulin around 10:45 AM this morning? Will that be your scheduled AM dose time?

    If you gave the AM shot around 10:45 AM, you should test again 1 hour after the last test - that blue number. The reason I'm suggesting this is that Java's BG is dropping faster than is desirable and you need to track that. He could be too low for comfort by +6 which is when the nadir usually occurs.
     
  53. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Could you please clarify your dose time this AM. Was it at 7 - 7:30 AM or was it later. I know you gave a dose late evening last night. There was discussion of switching to early AM today. I need to know that in order to understand your SS. It's possible that the o.5 u dose overlapped with the remnants of last night's late evening dose and that's the reason for the drop at +3.

    I think you can see from the questions I'm asking why we need to know you're following a structured routine. It's almost impossible to understand what's going on or be able to give advice without a routine.
     
    Last edited: Jan 30, 2017
  54. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    7:30 am BG was 227.
    .5 unit at 7:30 am.
    3 ish hrs later, at 10:45, 106 BG
    Just now, 4 pm, or 8.5 hrs later, 206

    He was sluggish at the 106 BG, three hours after. I woke him up before I had to leave, and he ate about a half a can of food, and seem brighter.

    I was back by 2 p.m. or 5.5 hrs later, and the two cats and I went outside to enjoy the sun. I thought of testing him, was not thinking of the nadir but more his behavior seemed okay, and typing the phrase 45 jabs in the last 6 days above gave me pause.

    I thought to test at 7 pm and go from there.

    He's behaving pretty normally. The weakness in his hind legs is noticeable but he's still jumping up on things using both legs as one unit. Wants my food as usual. Has had some FF.

    I'd like him to gain some weight back, and get better hind leg use back. It's hard to know what's the disease and what's his age.
    The YA food is on its way here, by Sat. He is craving crunchy food. So far, dehydrated chicken breasts chopped up or as close as he's going to get. The Accutrack arrived. I have 2 or 3 strips left from the 50 strip container rec'd on the 23rd.

    I think quite possibly no insulin tonight.

    Has anyone found a reuse for the test strip containers? They're very cool.
     
    Last edited: Jan 30, 2017
    Reason for edit: Add, edit info
  55. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Kris and Teasel, I don't think I've said Thank You adequately. Thank you so very much. And Lisa and Smoky and Larry. Thank you.
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You're welcome! I think things will fall into place now that you're embarking on a routine. I can't stress the importance of this enough.

    If his PMPS (evening preshot BG number) is similar to what it was this AM he'll absolutely need a dose of insulin, Lois. Even if his preshot numbers drop a little below 200 over time, he'll still need small doses unless/until he reaches remission. Insulin needs to be given on a strict every 12 hour schedule in cats because they metabolize it quickly. Dosing in a hit or miss way causes spikes and dives and makes regulation almost impossible. You'll have to resign yourself to that. :)

    I'll be watching for your PMPS test result. That 106 at +3 tells me he might have gone fairly low around +5 or +6. The yellow afterward suggests he's on his way back to a number like he had this AM or thereabouts. If so, you'd give 0.5 u again at 7 PM your time and do another test before bed or at +3, whichever comes first. You need to build up a data library of Java's responses to regularly dosed insulin.
     
  57. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I need to take up the food now!
     
  58. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes! :)
     
  59. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Time for PMPS. Let me know the number.
     
  60. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    280. 7:30 pm.
    1/2? 1/3?
    Will be setting alarms tonight, the adrenaline wore off and I'm so tired, am napping when the cats nap.
     
    Last edited: Jan 30, 2017
    Reason for edit: Combine 2 messages
  61. Kris & Teasel

    Kris & Teasel Well-Known Member

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    OK. Feed and give 0.5 u again tonight. Don't wait too long after feeding and the meal doesn't have to be large. No need for any more testing tonight. His ears will welcome the break. The same routine has to be repeated tomorrow. I'll be out when you post your AMPS - I'm 3 hours ahead of you (eastern Canada). If his AMPS is similar to this AM/PM, give 0.5 u again. Just building up your data collection ...
     
    Last edited: Jan 30, 2017
  62. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    0.5 u and you don't need to set any alarms tonight. You can do one last BG test before you go to bed and that should do. You'll find that as you continue with a structured routine patterns will emerge on his spreadsheet and you won't have to test as much because there'll be more predictability.
     
  63. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    .5 done.
    Okay! Thanks so much.
    I'm so sorry about the Ontario shooting.
    There's so much awful political news, it's part of the fatigue probably.
    Thanks again, wonderful persons over the Internet. I'm so grateful to have found this site.
     
  64. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I suggest you start posting on the ProZinc/PZI forum for insulin specific advice. The users tend to congregate there.
     
  65. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    165 at 12:15 am, midnight ish
    Had a big feed around 9:30, a good snack now.
    Will give him a break on the sticks until 7 AM-ish.
     
    Kris & Teasel likes this.
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I like that blue number. What type of syringe are you using - U40 with half unit marks? I ask because I want to know how you measure doses. We generally use 0.25 u increments, not 0.33 u.
     
  67. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    It's a miracle! Thanks for staying on me until I got this!
    292 this morning. .5 after some food. He's continuing to come back and eat more, which I like.
    I had an alarm set, but both cats woke me up by standing over my face and meowing at me. I'd pulled food up at 4:45 a.m. while up to pee.
    I have U-40s, two types from the vet, both of which only have one unit markings. I eyeball it, hold the syringe so the ceiling light from the next room shines through it. I'd asked the pharmacy and the vet for different types of syringes and neither had anything better than this. Where do people get U-40s with half markers?
     
  68. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I feel so bad now for putting Java through so much since October. Knock wood, this looks like it can continue being stable. Seriously thank you so much. It's stunning how unhelpful the vet was.
    I'll make a point today of doing a test at 6 hours.
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Many folks in the US order from adwdiabetes.com. I'm so glad you're seeing some light at the end of the proverbial tunnel. :)
     
  70. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I saw the blue 172 from this afternoon. Give 0.5 u again tonight just to keep things on an even keel. If he has a yellow preshot tomorrow AM, go up to 0.75 u. I'm suggesting the increment of 0.75 u because that's what you'll be eyeballing on a U40 syringe with half unit marks. Have you ordered any?
    https://www.adwdiabetes.com/product/carepoint-vet-u-40-syringe-29g-half-unit_16363_112.htm
    Let's avoid anything "non-standard" like 0.33 u for now.

    Your choice re another test late this evening. I don't think it's needed.
     
  71. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Java's hungry now, he'd probably appreciate not being jabbed.
    .5, check, no test until tomorrow am.
    I have Miralax now, will start with 1/8 tsp sprinkled on food.
    Why .75 instead of .5 tomorrow?
    I'm not sure where the .33 reference is coming from...?
    Have not ordered new needles. I have a lot of u40s now and feel okay about eyeballing .5, etc. but will get the new ones after these.
     
  72. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Right. Keep that same dose of 0.5 u for a third day. My error. When I mentioned 0.33 u it's because you asked me about it as a possibility for last night's dose. We usually stick to fractions of 0.25, 0.5 and 0.75 of a unit. If you can eyeball those on the syringes you have, that works.
     
  73. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    Hi Lois .. Tanya's Guide to CKD kitties also has really good info on how to treat constpation in a CKD kitty...her suggestions on Miralax dosing make wonderful sense. She says to start out 1/8 t ( full dose once a day or divided dose twice a day) for 3 days before increasing to 1/4 given the same way . Also has other good suggestions on the subject . Hope this helps .
     
  74. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I read about Miralax on Tanya's page earlier, there's also a thread about it here. I missed specific instructions to go with 1/8 for 3 days then increase it though. I imagine it depends on whether the 1/8 works or not, and 3 days should be enough to see. Good to know, thanks. That's a good website.
     
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I was looking for the PMPS number from last night but you haven't updated your SS yet. A third day at 0.5 u AM/PM will be your baseline data set. The dose will likely need to go up tomorrow, numbers permitting. Systematic ... ;)
     
  76. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I didn't test him last night. I thought that's what you suggested. I tested this morning. My mistake obviously. In other words, don't vary from the routine of: AM test, food, shot; PM test, food, shot. What might vary is the # of tests in between AM and PM.
     
  77. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, that's correct. Sorry if I wasn't clear about that. It's wise to get at least one other test either mid day or before bed. If it seems that BG is dropping low-ish then more testing is in order.
     
  78. Lois and Java

    Lois and Java Member

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  79. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I had an appt and wasn't home until 6:25 to take up food. Tested at 7:45, 368, higher than last two nights; food, then shot at 8. Could the later time be the difference in BG, or 1.5 hrs fasting instead of 2 before testing?
     
  80. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Probably food influenced.
     
  81. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I suggest that you go up to 0.75 u this AM. The three days at 0.5 u were to establish a baseline. The numbers say that slow dose increases are needed. Unless something changes, keep the 0.75 u for three days. Once you have a lot more data under this new structure it'll be possible to change doses more often as needed.
     
  82. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Okay. I think I should check around +5 to be sure not too low.
    Miralax and pumpkin not working super great yet, but he is pooping, just still hard nuggets that sometimes get stuck. One outside litter box this am, but improved over on the dining room table yesterday.
     
  83. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    >> Probably food influenced
    Same food, so different amounts ingested? He ate more, or the fasting wasn't as long.
     
  84. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, a test at +5 is a good idea.
     
  85. Lois and Java

    Lois and Java Member

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    >>Unless something changes, keep the 0.75 u for three days
    Check. Thanks!
    Curious -- How did you know his BG would start to go up?
     
  86. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I deleted my last post because I reconsidered what I said. The pink preshot numbers you got today could be bounces - an overreaction that raises BG in response to a low number or lower than is typical number. I suggest that you do a 12 hour curve tomorrow at the 0.75 u dose if your schedule permits. Take a BG reading every 2 hours between AM and PM preshots. That might give an indication of where his nadir is as well show how low this dose takes him.
     
  87. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    I can do that.
    His ear isn't bruised any more, it was good to take a break from so many sticks.
    I don't quite follow the rationale but I'm game.
    Assuming .5 sent him to a low of 117 -- if that's what you're looking at and I don't know that it is -- wouldn't .75 create a lower low?
    I believe we can rule out plain pumpkin as a cause of change? And miralax apparently is inert for BG purposes.
     
  88. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Woke up to pee, tested, 303, it's 2 am / +6. Am surprised. The 7:45 pm shot went in for sure, this test was a big drop of blood. He ate more than usual I think? We're both going back to sleep.
     
  89. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Logic says that if 0.5 u dropped his BG to 117 then 0.75 u should drop him further. That assumes a simple response to the insulin, ie., more insulin = lower BG. That's true for some cats who don't "bounce" or for bouncy cats some of the time. This phenomenon can make a dose that's too high look like a dose that's too low. I suggest you try searching this term on FDMB by using the search bar at the top right of this page. In a nutshell, bouncing is an overcompensation to a change in BG in which the cat's body converts glycogen stored in the liver to glucose for the bloodstream to counteract the perceived danger of BG dropping too low. The problem is that this response can be triggered by :
    1. a BG that truly does drop too low
    2. a BG that's lower than the cat is accustomed to even if not terribly low
    3. a high or higher than usual rate of descent of Bg after an insulin dose.
    The bounce to high numbers can produce a curve that looks like a dose isn't effective and the elevation can last a few days - or can be short lived, ie., a few hours. A short lived bounce can give high AM/PM numbers or just AM or PM. It's complicated and makes it harder to decide on doses and also to judge the effectiveness of a dose.

    It's possible that 0.75 u is too high a dose for Java. It's possible that he's doing some short term bouncing. That 303 in the middle of the night when he should have a lower BG suggests bouncing. The way to sort this out is to start with a BG curve done over 12 hours to see the response to a given dose. If his curve today looks high and flat after he's given you some blue numbers on this dose and the 0.5 u dose, there's a strong possibility that he's bouncing.

    So - how to proceed? The worst thing for bouncing is to jump around with dose level and timing. Consistency is key to finding out what's happening. The first thing is to do a curve. If it suggests bouncing, you hold the dose for several cycles (up to 6 usually) to see if the bouncing stops and BG drops as it should. Let's leave it at that for now.

    Treating FD is often much more complex than finding a dose and that's the dose going forward. The good dose is a moving target and some cats' response is highly variable. The goal of the systematic approach we promote here is to reduce the number of variables to a minimum.
     
    Last edited: Feb 3, 2017
  90. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    371 at 8:25 AM.
    .75 at 9:00

    Rereading from start, edit as go along. I could not rouse early again today, between 7:30-8:30 am has to become norm.

    Larry asked, could Java be eating different amounts at each meal?
    Yes absolutely he is, different amounts, diff times, every day, within parameters. Approx 1/4-1/3 C FF classic am, pm bowls, but he never finishes a helping. Never has, he's always been a grazer. His 'sister' will eat a whole portion, never Java.
    During day, I'll urge him to finish by taking food to where he is, or pick him up, take him to bowl. Am careful Lily doesn't get into bowl with miralax. Will make up new bowl during day, FF and dehydrated chicken always down except now the 2 hrs before am and pm testing am. Tests middle of day, night, not fasting tests.
    I'm doing it all wrong again, that's why people measure food and use the automatic feeders, isn't it.
     
    Last edited: Feb 3, 2017
  91. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    OK. If 8 AM suits you better and you're around to do 8 PM testing, etc. by all means move the scheduled times. It has to work for you. You can still do the curve today if you're home.
     
  92. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I see that green 97 at +2 this AM. That's a very large drop so soon after the AM dose. PZI is usually slower in onset than this. To clarify:
    • AMPS was 371
    • Was Java fed before injecting?
    • 0.75 u given before or after food? (should be after or at minimum while eating)
    • BG at +2 was 97
    • fed again at +2 or +3
    • BG at +4 was 167
    I'm unsure of why you got a 97 so early in the cycle: shot before feeding? incorrect dose drawn up accidentally? It's best if meals are given AM/mid cycle/PM/bedtime especially when doing a curve. Sorry for not emphasizing that.
     
  93. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Java was tested. Then fed. Then got a shot.
    He consistently had big fast drops with insulin before, then gradual gains, under the erratic protocal I was trying before with the non-help from the vet.
    Maybe it's from the increase from .5 to .75?
    I don't know. It's possible he had a big drop and then a gain under .5 but I wasn't testing him that close to the AM dose.
     
  94. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Has he always been on PZI insulin? I know that Vetsulin/Novolin/NPH can drop them fast but as we say, ECID - "every cat is different". I suggest you finish up today's curve and go from there. It's possible that he reacted to the 50% increase from 0.5 u to 0.75 u. That's a big increase in proportion to the magnitude of the dose. You might have a lot of U40s in whole units left but I suggest you buy others with half unit marks. You could dose just over the 0.5 u line. At tiny doses like this there's a large margin of error when eyeballing between whole unit marks.
     
  95. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    Yes, always PZI. I didn't know there were other types until coming here.
    Okay, will order some U-40s with .5 markers. It's possible by eyeballing it, that it's closer to 2/3 than 3/4. You're right, small area.
    edit to add, stick with .75 for 3 days?
     
    Last edited: Feb 3, 2017
  96. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Give 0.75 u tonight and do a +2 test because of what happened this AM. If this is his pattern you need to know that. Give him a snack around +2 or +2.5 is he seems to be diving. I'll be in bed when this late testing happens because I'm 3 hours ahead of you. If he's low-ish tomorrow AM I might suggest backing off on the dose. He's a low dose kitty and appears to be quite insulin sensitive. Caution is needed.
     
  97. Lois and Java

    Lois and Java Member

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    Oct 21, 2016
    He laps up such small amounts at every feeding, I take his bowl to him several times over the morning. All day really.
    I knew he had big drops from insulin from the handwritten graphs at the very top, 3 from historical info, and 1 from regular testing when I first got here.
    If it's possible that a big low is created by a higher dose of insulin, then my hunch is that the 368 BG PM on 2/1 could have been ignored as a lone outlier, and .5 stuck to for a while longer. What do you think?
     
  98. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Yes, it's possible. If you'd feel more comfortable going back to 0.5 u this evening, that's fine. It's very difficult to explain individual BG numbers. What tells the story is the trend in numbers at various doses over time. The scattering of pinks, yellows , blues, etc. on the SS are revealing. That's why we keep stressing systematic data gathering.
     
  99. Lois and Java

    Lois and Java Member

    Joined:
    Oct 21, 2016
    Oh crikey, I'm an hour late. Okay, 332 at 4 PM, let's see. Thats +7.
    Edit to add: just saw your message above. I will do .5 tonight.*
    I hope it isn't just grasping at straws to hope to find a dose that more or less is the same thing every AM and PM!
    * re times. His AM test + food took long enough that he didn't get a shot until 9 AM today.
    I'd like to try to stick as close to 8 AM / 8 PM as possible. Tonight, go for 8 PM instead of 9 PM?
    How feasible is it to go for 8 AM, 7 PM, which would be my ideal?
     
    Last edited: Feb 3, 2017
  100. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    No problem. You can either wait until +9 for the next one or do a +8 to get back on track.
     
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